Improvements in Pain, Physical Function Achieved With Guselkumab in Patients With Treatment-Resistant PsA

Patients with treatment-resistant psoriatic arthritis (PsA) experienced clinically meaningful improvements in health-related quality of life (HRQoL) factors, such as pain, fatigue, and discomfort after 6 months of treatment with guselkumab.

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This analysis study is published in ACR Open Rheumatology.

“To our knowledge, this is the first real-world study to evaluate the longitudinal effectiveness of guselkumab for improvement of PROs [patient reported outcomes] in patients with active PsA,” wrote the researchers of the study. “This analysis evaluated multiple validated PRO measures with stringent response thresholds.”

The study aimed to examine patient-reported outcomes in patients enrolled in the CorEvitas PsA/Spondyloarthritis Registry (NCT02530268) with PsA, after 6 months of treatment with on-label guselkumab 100 mg at weeks 0, 4, and 8. All patients included in the study had a 6-month follow-up visit on or before March 31, 2023.

The registry included patients from 68 private and academic sites across 30 states. Out of a total of 5,996 enrolled patients, 82.9% with PsA were included in the dataset for this analysis.

The analysis evaluated pain, physical function, and overall disease activity, measured using a 0 to 100 mm visual analog scale for patients to report their worst pain within the past week. Additionally, pain was assessed using the Widespread Pain Index (PWI). Physical function was measured using the Health Assessment Questionnaire-Disability Index (HAD-DI) and fatigue was assessed using the Bath Ankylosing Spondylitis Disease Activity Index.

Furthermore, the researchers used the Patient Global Assessment of arthritis and psoriasis (PtGA) to examine the overall effects of arthritis and psoriasis.

A total of 90 patients completed the study, in which most had treatment-resistant PsA (92.2%) and 73.3% had previously received at least 1 and at least 2 biologic/targeted synthetic disease-modifying antirheumatic drugs, respectively, with a mean (SD) baseline patient-reported pain score of 57 (24.6), PtGA of 50.3 (24.4), and HAQ-DI of 0.9 (0.6), respectively.

Additionally, 40.2% of individuals with patient-reported pain scores of at least 15 at baseline and 46.8% of individuals with PtGA scores of at least 15 at baseline achieved at least 15mm reductions at 6 months, respectively. Among individuals with HAQ-DI scores of at least 0.35 and more than 0.5 at baseline, 30.4% achieved improvements of at least 0.35, with 10.3% who achieved scores of 0.5 or lower at 6 months (P < .001).

However, the researchers acknowledged some limitations to the study, including having a small sample size and possible time and selection biases. Additionally, the researchers noted these findings may not be generalizable to patients outside of the US or to those who received guselkumab but do not meet the definition of On-Label Persisters.

Despite these limitations, the researchers believe the study showed the benefits of treatment with guselkumab among a population of patients with treatment-resistant PsA at 6 months.

“This real-world population of patients characterized by longstanding, treatment-resistant active PsA and with persistent on-label guselkumab use achieved clinically meaningful improvements in pain, fatigue, and physical function,” wrote the researchers. “Therapies that provide improvement in these symptom domains, which are highly important to patients and often difficult to treat, may yield clinically important benefits in patients’ overall HRQoL”.

Reference

Mease PJ, Ogdie A, Tesser J, et al. Improvements in patient-reported outcomes through six months of guselkumab treatment in patients with active psoriatic arthritis: real-world data from the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry. ACR Open Rheumatol. Published online February 28, 2024. doi:10.1002/acr2.11657