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The Need for Comparative Treatment Trials in Psoriatic Arthritis

Richard Conway, MBBChBAO, PhD

Psoriatic arthritis is currently experiencing a burgeoning selection of treatment options. While this is a very welcome development in a disease which has had less treatment options compared to RA, it leaves us with a difficult conundrum: which agent to choose for an individual patient.

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Guselkumab in Psoriatic Arthritis

Pedro Castillo

D1 and D2 trials compared guselkumab vs placebo in patients with active PsA, with the major difference between the two being that only biologic-naïve patients were enrolled in the D2 trial. Today, we discuss three abstracts presented at ACR 2021 that expand on that work with an additional year of data.

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ACR Best

ACR21 Best Abstracts - Day 1

Jack Cush, MD

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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Risankizumab for Active Psoriatic Arthritis

Robert Chao, MD

The arsenal of therapeutics for psoriatic arthritis continues to increase. Risankizumab is an IL-23 inhibitor to the p19 subunit, currently being investigated for treatment of psoriatic arthritis.

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Phase 2 trial of tildrakizumab (IL-23i) for the treatment of PsA showed lower efficacy in pts with metabolic syndrome compared to those without #ACR21 @RheumNow Abs#1819 https://t.co/GYHbiH9NSW https://t.co/YGcZcITjzj

Links:

Robert B Chao, MD doctorRBC ( View Tweet)
2 year study shows low rates of radiographic progression in PsA pts on guselkumab #ACR21 @RheumNow Abs#1805 https://t.co/dobg3cEXXG https://t.co/m1P24qPAhy

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Robert B Chao, MD doctorRBC ( View Tweet)
Abst1773 #ACR21 @rheumnow guselkumab outperforms ustekinumab in both msk & skin domains in bio naive & bio experienced alike- data from pivotal Phase III trials : at weeks 52 GUS better ACR20, PASI100 in both doses vs Stelara https://t.co/lfddaCJA5O
Olga Petryna DrPetryna ( View Tweet)
No benefit to using MTX in combination with ustekinumab in PsA. No difference in efficacy for arthritis, enthesitis, dactylitis, skin, QoL or function. Abstr#L12 #ACR21 @RheumNow https://t.co/iojKLqRb06
Richard Conway RichardPAConway ( View Tweet)
Individual patient data analysis from RCTs (indirect comparison) of guselkumab vs ustekinumab in PsA. Guselkumab appears superior for joint and skin. Abstr#1773 #ACR21 @RheumNow https://t.co/MTRjXyHoh6
Richard Conway RichardPAConway ( View Tweet)
Guselkumab 100 mg Q4W and Q8W provided robust and sustained benefits to patients with active PsA across multiple domains. Listen to my interview with Prof. Laura Coates on this and other emerging treatments in PsA here https://t.co/PSbJ0HA5a6 @RheumNow #ACR21 Abstr#1335 https://t.co/WzBOYGOxAA

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Dr. Antoni Chan synovialjoints ( View Tweet)
Supporting date for Ixekizumab in PsA with symptoms of axial involvement. 🔹Improvement in QoL (SF-36), ASDAS, BASDAI50 🔹Maintained at 52 weeks 🔹Stricter criteria (younger, ⬆️CRP) showed similar results https://t.co/QSJLQTxLcW #ACR21 Abst#3147 @RheumNow

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Pedro Castillo _Castillo_Pedro ( View Tweet)

Dr Oster presenting on IL-23 inhibitor Risankizumab in PsA. No surprises here, it works. We need comparative efficacy trials! Abstr#0453 #ACR21 @RheumNow https://t.co/mj8TeCqEcg
Richard Conway RichardPAConway ( View Tweet)
Risankizumab for Active Psoriatic Arthritis with Dr. Robert Chao ( @doctorRBC ) #ACR21 https://t.co/0zskkywWu1 https://t.co/n3qs19rQNG

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Dr. John Cush RheumNow ( View Tweet)
Guselkumab treatment of PsA improved Hgb levels and ⬇️ incidence of anemia ⭐️Anemia resolution associated with improved clinical status #ACR21 #ACRBest Abs#1331 @RheumNow https://t.co/nbG7DpMDaR https://t.co/rxWsVfNqed

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Robert B Chao, MD doctorRBC ( View Tweet)
Low incidence of GI-related serious AE in pooled 1 year data from VOY1&2 and DISC1&2 trials of Guselkumab for PsA/PsO treatment ⭐️no new onset IBD or exacerbation of IBD ⭐️no uveitis, infections, TB Abs#1342 #ACR21 @RheumNow https://t.co/x3OmLgInV0

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Robert B Chao, MD doctorRBC ( View Tweet)

SEC demonstrated significantly longer time to flare vs PBO w/ sustained improvement of ERA and JPsA signs and symptoms up to Wk 104. No new safety signals. Plenary Abs 1424 #ACR21 #RheumNow @RheumNow https://t.co/VF2HmJ3Ha9 https://t.co/ApYFusADHX

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Dr. Rachel Tate uptoTate ( View Tweet)
Abst1424 #ACR2021 @RheumNow study of SEC in children w/ERA or JPsA : 72% reduced flare risk. Improved JADAS-27 score in both the ERA and JPsA categories. ⬇️ disease activity, enthesitis count & joints with active arthritis. adverse events & serious AEs in the SEC & PBO comparable https://t.co/J4MdxeYxWZ
Olga Petryna DrPetryna ( View Tweet)
Guselkumab improves anaemia in PsA. Appears to correlate with CRP response, ie inflammatory effect. Anaemia resolution associated good outcomes, but many with good outcomes still anaemic. Abstr#1331 #ACR21 @RheumNow https://t.co/LL63Qc0nk5
Richard Conway RichardPAConway ( View Tweet)
Guselkumab (IL23p19 inhibitor) positive effect on axial outcomes in PsA, durable response across 2 years. Abstr#1330 #ACR21 @RheumNow https://t.co/8LOSdzCvRc
Richard Conway RichardPAConway ( View Tweet)
⁦@JointMD⁩ shares his thoughts on IL23, IL17, TNF inh- where/when/how we might use them. ⁦@RheumNow⁩ #acr21 https://t.co/mVw05iFPhF

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TheDaoIndex KDAO2011 ( View Tweet)

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