New data from the PsABIOnd study presented at the American College of Rheumatology (ACR) Convergence 2024 indicates that guselkumab and IL-17 inhibitors exhibit comparable real-world efficacy in treating psoriatic arthritis (PsA). The observational study, which included 360 patients receiving guselkumab and 326 receiving IL-17 inhibitors, suggests that both treatments offer similar benefits in terms of disease control and treatment persistence.
Comparable Treatment Persistence and Efficacy
The study, led by Laure Gossec, MD, PhD, from Pitié-Salpêtrière Hospital and Sorbonne University, assessed treatment persistence and efficacy over a 6-month period. Results showed high treatment persistence in both groups, with 94.2% of the guselkumab group and 93.3% of the IL-17 inhibitor group remaining on their initial treatments. The PS-adjusted hazard ratio of GUS vs IL-17i stop/switch was 0.87 (95% CI, 0.47-1.61).
Efficacy outcomes were also similar between the two groups. Specifically, 39.7% (95% CI, 32.2-47.3) of the guselkumab group and 34.3% (95% CI, 27.3-41.7) of the IL-17 inhibitor group achieved cDAPSA LDA/REM (low disease activity/remission). DAPSA LDA/REM was achieved by 38.0% (95% CI, 30.0-46.5) of the guselkumab group compared with 38.9% (95% CI, 31.1-47.2) of the IL-17 inhibitor group. Additionally, psoriasis body surface area <3% was achieved by 34.9% (95% CI, 29.7%-40.1) of the guselkumab group and 31.5% (95% CI, 26.1-36.9) of the IL-17 inhibitor group.
Shared Decision-Making in PsA Treatment
Dr. Gossec emphasized the importance of shared decision-making in PsA management, noting the significant patient burden associated with the disease and its comorbidities. "We really need to insist on the importance of shared decision making in PSA, because it's a disease where the patient burden is really high, not only because of the disease itself, the skin involvement, but also the comorbidities. And we really need to make the best choice for our patients," Gossec stated.
The study provides valuable real-world evidence supporting the use of both guselkumab and IL-17 inhibitors in the treatment of psoriatic arthritis, highlighting the need for individualized treatment approaches based on patient-specific factors.
