Effectiveness of ustekinumab in patients with psoriatic arthritis in a real-world, multicenter study

Azuaga, Ana Belén; Frade‐Sosa, Beatriz; Laíz, A.; Estrada, Paula; Prior-Español, Águeda; Horcada, Loreto; Polino, L.; Moreno, M.; Moragues, C.; Urruticoechea‐Arana, Ana; Sellas‐Fernández, Agustí; Tandaipan, J. L.; Torrente-Segarra, V.; García-Miguel, J.; Ros, Inmaculada; Ordoñez, S.; Moya, Patricia; Reina, Dèlia; Mateo-Soria, Lourdes; Fito, C.; Beltrán, E.; Pujol, M.; Cuervo, Andrea; Cañete, Juan D.; Ramírez, Julio

doi:10.1007/s10067-020-05057-9

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…8,24,25 A similar pattern is seen in real-world studies, with patients with inadequate response or intolerance to TNFα inhibitors reporting lower effectiveness and greater rates of treatment discontinuation or switching compared with patients who are naive to TNFα inhibitors. 26,27 Given the lower effectiveness in this population, as well as the continued adoption of TNFα inhibitor treatments and TNFα inhibitor biosimilars as first-line therapies, efficacy in patients with inadequate response or intolerance to TNFα inhibitors with psoriatic arthritis becomes increasingly relevant. The efficacy of bimekizumab in this difficult-totreat population of patients with inadequate response or intolerance to TNFα inhibitors could be due to an enrichment of patients with IL-17F-dependent signalling driving their disease, which cannot be inhibited by TNFα inhibitors or other treatments that only target IL-17A.…”

Section: Discussionmentioning

confidence: 99%

Bimekizumab in patients with active psoriatic arthritis and previous inadequate response or intolerance to tumour necrosis factor-α inhibitors: a randomised, double-blind, placebo-controlled, phase 3 trial (BE COMPLETE)

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Bimekizumab in patients with active psoriatic arthritis and previous inadequate response or intolerance to tumour necrosis factor-α inhibitors: a randomised, double-blind, placebo-controlled, phase 3 trial (BE COMPLETE)

et al. 2023

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“…RWE are scarce about SEK and UST in PsA. Two studies reported the persistence of UST in PsA [16,18]. Azuaga et al showed a 12-month persistence rate of 64.1% in 201 Spanish patients with PsA treated with UST.…”

Section: Discussionmentioning

confidence: 99%

“…bDMARD-naïve patients and those treated with one prior TNFi had a significantly higher 12month persistence rate than patients treated with two or more prior TNFi. Discontinuation due to inefficacy was the most frequent cause (72.9%) [18]. Walsh et al analysed data of patients who initiated therapy with a bDMARD for PsA obtained from the Optum Research FIG.…”

Section: Discussionmentioning

confidence: 99%

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Secukinumab and ustekinumab treatment in psoriatic arthritis: results of a direct comparison

Letarouilly

Flachaire

Labadie³

et al. 2020

Rheumatology

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Objectives To evaluate the characteristics of patients (pts) with PsA treated by ustekinumab (UST) or secukinumab (SEK) and to compare real-world persistence of UST and SEK in PsA. Methods In this retrospective, national, multicentre cohort study, pts with PsA (CASPAR criteria or diagnosis confirmed by the rheumatologist) initiating UST or SEK with a follow-up ≥6 months were included from January 2011 to April 2019. The persistence between SEK and UST was assessed after considering the potential confounding factors by using pre-specified propensity-score methods. Causes of discontinuation and tolerance were also collected. Results A total of 406 pts were included: 245 with UST and 161 with SEK. The persistence rate was lower in the UST group compared with the SEK group [median persistence 9.4 vs 14.7 months; 26.4% vs 38.0% at 2 years; weighted hazard ratio (HR) = 1.42; 95% CI: 1.07, 1.92; P =0.015]. In subgroup analysis, the persistence rate of SEK associated with MTX was significantly higher than that of UST associated with MTX: HR = 2.20; 95% CI: 1.30, 3.51; P =0.001, in contrast to SEK vs UST monotherapy: HR = 1.06; 95% CI: 0.74, 1.53; P =0.75. Discontinuation due to inefficacy was reported in 91.7% (SEK) and 82.4% (UST) of pts. Discontinuation due to an adverse event was reported in 12.2% (SEK) and 7.7% (UST) of pts. Conclusion In this first study comparing UST and SEK, the persistence of SEK was higher than that of UST in PsA. In subgroup analysis, this difference was only found in association with MTX.

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“…This is likely to have been due to the small number of patients with arthritis in those series, which meant that a real relationship of a broadly similar magnitude to the one we noted would not have been statistically significant with such a small sample size (beta-type error). It has recently been reported that retention rate of ustekinumab 90 mg was 76.1% after a median time of 12 months follow up in patients with psoriatic arthritis in a real-world setting [40]. Studies investigating ustekinumab survival on a large cohort of patients with psoriatic arthritis, in order to replicate these findings, are required.…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab Drug Survival in Patients with Psoriasis: A retrospective Study of Real Clinical Practice

et al. 2020

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Background and objectives: The efficacy and safety of ustekinumab have been proved in clinical trials. In daily clinical practice, knowing the factors that determine survival differences of biological drugs allows psoriasis treatment to be optimized as a function of patient characteristics. The main objectives of this work are to understand ustekinumab drug survival in patients diagnosed with plaque psoriasis in the Hospital Universitario Central de Asturias (HUCA Dermatology Department, and to identify the predictors of drug discontinuation. Materials and Methods: A retrospective hospital-based study, including data from 148 patients who were receiving ustekinumab (Stelara®) between 1 February 2009 and 30 November 2019, were collected. Survival curves were approximated through the Kaplan–Meier estimator and compared using the log-rank test. Proportional hazard Cox regression models were used for multivariate analyses while both unadjusted and adjusted hazard ratios (HR) were used for summarizing the studied differences. Results: The average duration of the treatment before discontinuation was 47.57 months (SD 32.63 months; median 41 months). The retention rates were 82% (2 years), 66% (5 years), and 58% (8 years). Median survival was 80 months (95% confidence interval. CI 36.9 to 123.01 months). The survival study revealed statistically significant differences between patients with arthritis (log-rank test, p < 0.001) and those who had previously received biological treatment (log-rank test, p = 0.026). The five-year prevalence in patients still under treatment was 80% (those without arthritis) and 54% (arthritis patients). In the multivariate analysis, only the patients with arthritis had a lower rate of drug survival. No statistically significant differences were observed for any of the other comorbidities studied. The first and second most frequent causes of discontinuation were secondary failure and arthritis inefficacy, respectively. Conclusion: Ustekinumab is a biological drug conferring high survival in plaque psoriasis patients. Ustekinumab survival is lower in patients with arthritis.

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Effectiveness of ustekinumab in patients with psoriatic arthritis in a real-world, multicenter study

Cited by 5 publications

References 23 publications

Bimekizumab in patients with active psoriatic arthritis and previous inadequate response or intolerance to tumour necrosis factor-α inhibitors: a randomised, double-blind, placebo-controlled, phase 3 trial (BE COMPLETE)

Bimekizumab in patients with active psoriatic arthritis and previous inadequate response or intolerance to tumour necrosis factor-α inhibitors: a randomised, double-blind, placebo-controlled, phase 3 trial (BE COMPLETE)

Secukinumab and ustekinumab treatment in psoriatic arthritis: results of a direct comparison

Ustekinumab Drug Survival in Patients with Psoriasis: A retrospective Study of Real Clinical Practice

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