Effectiveness of ustekinumab in patients with psoriatic arthritis in a real-world, multicenter study
Por:
Azuaga, AB, Frade-Sosa, B, Laiz, A, Estrada, P, Prior-Espanol, A, Horcada, L, Polino, L, Moreno, M, Moragues, C, Urruticoechea-Arana, A, Sellas, A, Tandaipan, JL, Torrente-Segarra, V, Garcia-Miguel, J, Ros, I, Ordonez, S, Moya, P, Reina, D, Mateo-Soria, L, Fito, C, Beltran, E, Pujol, M, Cuervo, AM, Canete, JD, Ramirez, J
Publicada:
1 oct 2020
Ahead of Print:
1 abr 2020
Resumen:
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 naive 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.
Filiaciones:
Azuaga, AB:
Hosp Clin Barcelona, Arthrit Unit, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Frade-Sosa, B:
Hosp Clin Barcelona, Arthrit Unit, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Laiz, A:
Hosp Santa Creu & Sant Pau, Rheumatol Dept, Barcelona, Spain
Estrada, P:
Hosp Moises Broggi, Rheumatol Dept, Barcelona, Spain
Prior-Espanol, A:
Hosp Badalona Germans Trias & Pujol, Rheumatol Dept, Barcelona, Spain
Horcada, L:
Hosp Navarra, Rheumatol Dept, Pamplona, Spain
Polino, L:
Hosp del Mar, Rheumatol Dept, Barcelona, Spain
Moreno, M:
UAB, Hosp Univ Parc Tauli, I3PT, Rheumatol Dept, Sabadell, Spain
Moragues, C:
Hosp Plato, Rheumatol Dept, Barcelona, Spain
Urruticoechea-Arana, A:
Hosp Can Misses, Rheumatol Dept, Ibiza, Spain
Sellas, A:
Hosp Arnau Vilanova, Rheumatol Dept, Lleida, Spain
Tandaipan, JL:
Hosp Univ Mutua Terrassa, Rheumatol Dept, Barcelona, Spain
Torrente-Segarra, V:
Hosp IAlt Penedes, Rheumatol Dept, Barcelona, Spain
Garcia-Miguel, J:
Hosp Univ Sagrat Cor, Rheumatol Dept, Barcelona, Spain
Ros, I:
Hosp Son Llatzer, Rheumatol Dept, Mallorca, Spain
Ordonez, S:
Hosp Arnau Vilanova, Rheumatol Dept, Lleida, Spain
Moya, P:
Hosp Santa Creu & Sant Pau, Rheumatol Dept, Barcelona, Spain
Reina, D:
Hosp Moises Broggi, Rheumatol Dept, Barcelona, Spain
Mateo-Soria, L:
Hosp Badalona Germans Trias & Pujol, Rheumatol Dept, Barcelona, Spain
Fito, C:
Hosp Navarra, Rheumatol Dept, Pamplona, Spain
Beltran, E:
Hosp del Mar, Rheumatol Dept, Barcelona, Spain
Pujol, M:
Hosp Univ Mutua Terrassa, Rheumatol Dept, Barcelona, Spain
Cuervo, AM:
Hosp Clin Barcelona, Arthrit Unit, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Canete, JD:
Hosp Clin Barcelona, Arthrit Unit, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Ramirez, J:
Hosp Clin Barcelona, Arthrit Unit, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
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