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

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Abstract

Objective

To assess the effectiveness and survival of ustekinumab (UST) among patients with psoriatic arthritis (PsA) treated under routine clinical care.

Methods

Multicenter study. Epidemiological and clinical data was collected through electronic medical records of all patients with PsA who started UST in 15 hospitals of Spain.

Results

Two hundred and one patients were included, 130 (64.7%) with 45 mg and 71 (35.3%) with 90 mg. One hundred and thirty one patients (65.2%) had previously received another biological therapy. The median baseline DAS 28 ESR was 3.99, and Psoriasis Area and Severity Index (PASI) was 3. Overall, there was a significant decrease in DAS66/68 CRP, swollen joint count (SJC), tender joint count (TJC), and PASI in the first month of treatment, with earlier improvement in skin (PASI) than joints outcomes. Survival was numerically lower in patients with UST 45 mg (58.1%) than 90 mg (76.1%), although significant differences were not found (p = 0.147). When comparing naïve and < 1 TNF blocker versus > 2 TNF blocker-experienced patients, a significantly earlier response was seen in the former group regarding SJC (p = 0.029) at 1 month. Fifty-one patients (25.3%) stopped UST due to joint inefficacy and 4 patients due to adverse events (1.9%). Drug survival was significantly better in patients with fewer lines of previous biological agents (p = 0.003 for < 1 TNF blocker versus > 2 TNF blocker users).

Conclusions

UST was effective in PsA patients in a routine clinical care setting. Patients with UST 90 mg and fewer lines of previous biologics achieved better and faster responses.

Key Points

• Largest cohort of patients with PsA in treatment with UST with specific rheumatological indication.

• First cohort of patients with PsA comparing effectiveness of UST according to 45/90 mg dose.

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Authors and Affiliations

  1. Arthritis Unit, Rheumatology Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain

    A. B. Azuaga, B. Frade-Sosa, A. M. Cuervo, J. D. Cañete & Julio Ramírez

  2. Rheumatology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain

    A. Laiz & P. Moya

  3. Rheumatology Department, Hospital Moisès Broggi, Barcelona, Spain

    P. Estrada & D. Reina

  4. Rheumatology Department, Hospital Germans Trias i Pujol, Barcelona, Spain

    A. Prior-Español & L. Mateo-Soria

  5. Rheumatology Department, Hospital Navarra, Pamplona, Spain

    L. Horcada & C. Fito

  6. Rheumatology Department, Hospital del Mar, Barcelona, Spain

    L. Polino & E. Beltrán

  7. Rheumatology Department, Hospital Universitari Parc Taulí, I3PT, UAB, Sabadell, Spain

    M. Moreno

  8. Rheumatology Department, Hospital Platò, Barcelona, Spain

    C. Moragues

  9. Rheumatology Department, Hospital Can Misses, Ibiza, Spain

    A. Urruticoechea-Arana

  10. Rheumatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain

    A. Sellas

  11. Rheumatology Department, Hospital Universitari Mútua Terrassa, Barcelona, Spain

    J. L. Tandaipan & M. Pujol

  12. Rheumatology Department, Hospital l’Alt Penedès, Barcelona, Spain

    V. Torrente-Segarra

  13. Rheumatology Department, Hospital Universitari Sagrat Cor, Barcelona, Spain

    J. Garcia-Miguel

  14. Rheumatology Department, Hospital Son Llàtzer, Mallorca, Spain

    I. Ros

  15. Rheumatology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain

    S. Ordoñez

Authors
  1. A. B. Azuaga
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  2. B. Frade-Sosa
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  3. A. Laiz
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  4. P. Estrada
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  5. A. Prior-Español
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  6. L. Horcada
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  7. L. Polino
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  8. M. Moreno
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  9. C. Moragues
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  12. J. L. Tandaipan
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  14. J. Garcia-Miguel
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  15. I. Ros
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  16. S. Ordoñez
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  17. P. Moya
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  18. D. Reina
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  19. L. Mateo-Soria
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  20. C. Fito
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  21. E. Beltrán
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  22. M. Pujol
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  23. A. M. Cuervo
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  24. J. D. Cañete
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  25. Julio Ramírez
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Correspondence to Julio Ramírez.

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Azuaga, A.B., Frade-Sosa, B., Laiz, A. et al. Effectiveness of ustekinumab in patients with psoriatic arthritis in a real-world, multicenter study. Clin Rheumatol 39, 2963–2971 (2020). https://doi.org/10.1007/s10067-020-05057-9

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  • DOI: https://doi.org/10.1007/s10067-020-05057-9

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