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Drug survival and effectiveness of ustekinumab in patients with psoriatic arthritis. Real-life data from the biologic Apulian registry (BIOPURE)

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Abstract

This study aims to evaluate the drug survival and effectiveness of ustekinumab in psoriatic arthritis (PsA) patients naïve to biologics or inadequate responders to tumor necrosis factor (TNF-IR) inhibitors in real life. PsA patients starting ustekinumab were enrolled from 2014 to 2016. Joint involvement, peripheral or axial, Psoriatic Area Severity Index, Disease Activity Psoriatic Arthritis (DAPSA), Lee Enthesitis Index, Health Assessment Questionnaire, body mass index, comorbidities, co-therapies, mechanism of action, and causes of discontinuation of prior TNFi were collected at baseline, and 6 and 12 months. Twelve-month drug survival was evaluated by Kaplan–Meier curves. Hazard ratios (HRs) of drug discontinuation adjusted for baseline factors were estimated by multiple Cox regression analysis. Percentages of DAPSA-based remission, as crude value and adjusted for drug retention (LUNDEX index), were compared by χ2 test. Mean differences of DAPSA from baseline to 6 and 12 months were compared between naïve and TNF-IR patients by ANOVA. Of 160 PsA patients starting ustekinumab, 54 were naïve and 106 were TNF-IR. Twelve-month drug survival was significantly higher in naïve (87%) than in TNF-IR (68%, p = 0.01). Baseline co-therapy with methotrexate did not increase the persistence on ustekinumab. Naïve patients had the lowest risk of ustekinumab discontinuation (HR 0.27, p = 0.01), and the highest DAPSA-based remission (34%, LUNDEX 26%). Mean differences from baseline of DAPSA was significantly greater in naïve than in TNF-IR patients at 12 months (− 14.4 ± 10 vs. − 4.1 ± 17, p = 0.01). Our data showed that ustekinumab has a good effectiveness in real life and the best outcomes are achieved in biologic-naïve PsA patients.

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  • 21 February 2018

    In Fig. 1 - paned D, incorrect image was published. This is now presented correctly in this article.

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Author notes

  1. Florenzo Iannone and Leonardo Santo contributed equally to this work.

Authors and Affiliations

  1. Department of Emergency and Organ Transplantation—Rheumatology Unit, Policlinico, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy

    Florenzo Iannone, Crescenzio Scioscia & Giovanni Lapadula

  2. Rheumatology Service, DSS4 Barletta ASL BT Andria, Barletta, Italy

    Leonardo Santo

  3. Rheumatology Hospital Unit, A.O.U. “OO.RR. Foggia”, Foggia, Italy

    Romano Bucci

  4. UO of Rheumatology, ASL Taranto, Taranto, Italy

    Angelo Semeraro & Antonio Marsico

  5. Rheumatology Service, ASL Lecce—DSS Casarano and Gallipoli (LE), Casarano, Italy

    Giorgio Carlino

  6. Asrem Rheumatology Service, SF Caracciolo Hospital, Agnone, IS, Italy

    Franco Paoletti

  7. U.O. of Rheumatology, “V.Fazzi” Hospital, Lecce, Italy

    Laura Quarta & Maurizio Muratore

  8. Rheumatology Service, ASL Lecce DSS Maglie, Maglie, Italy

    Pierfrancesco Leucci

  9. Hospital Outpatient Clinic of Rheumatology, ASL BR, Brindisi, Italy

    Carmelo Zuccaro & Daniela Mazzotta

  10. UOC Reumatologia Universitaria, University of Foggia, Foggia, Italy

    Francesca D’Onofrio & Francesco Paolo Cantatore

Authors
  1. Florenzo Iannone
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  2. Leonardo Santo
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Correspondence to Florenzo Iannone.

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A correction to this article is available online at https://doi.org/10.1007/s10067-018-4033-2.

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Iannone, F., Santo, L., Bucci, R. et al. Drug survival and effectiveness of ustekinumab in patients with psoriatic arthritis. Real-life data from the biologic Apulian registry (BIOPURE). Clin Rheumatol 37, 667–675 (2018). https://doi.org/10.1007/s10067-018-3989-2

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