The use of guselkumab in psoriatic arthritis: evidence from real clinical practice
https://doi.org/10.14412/1996-7012-2021-6-91-94
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints, spine and enthesis from the group of spondyloarthritis that develops in patients with psoriasis. Guselkumab is a biologic disease-modifying antirheumatic drug, an inhibitor of interleukin 23, which has been shown to be effective in the treatment of plaque psoriasis and PsA.
Objective: to evaluate the effectiveness of guselkumab treatment in PsA patients.
Patients and methods. The study included 16 patients with PsA. All patients received 100 mg of guselkumab subcutaneously at weeks 0, 4, 12, 20. Disease activity and treatment efficacy were assessed at weeks 0, 12 and 24 using the DAS28, ASDAS, BASDAI, DAPSA activity indices, the index of the extent and severity of psoriasis PASI.
Results and discussion. During treatment, patients with PsA showed a pronounced positive dynamics of the indices of disease activity and an improvement in the skin condition. Before the treatment with guselkumab, the mean value of the DAS28 index was 4.26±0.64, DAPSA – 37.94±9.45, ASDAS – 2.7±0.65, and BASDAI – 5.49±1.39, after 12 weeks of treatment these indicators decreased to 3.03±0.49; 17.06±4.58; 1.64±0.33 and 3.48±0.66, respectively, and after 24 weeks (after the 4th injection) – to 2.32±0.18; 11.31±2.18; 1.22±0.27 and 2.62±0.78, respectively (p<0.05 for all cases). Before treatment, the average PASI index reached 30.99±15.43, after 12 weeks – 4.55±4.82, and after 24 weeks – 1.05±1.46 (p<0.05). During treatment, a significant improvement in the main manifestations of the disease was noted: regression of peripheral arthritis, spondylitis, and skin rashes.
The treatment was well tolerated during the 24 weeks of the study, and no serious adverse events were reported.
Conclusion. The data from real clinical practice indicate that guselkumab is highly effective and safe in the treatment of PsA.
Supporting agencies: This article has been supported by Janssen.
About the Authors
N. V. Nekrasova
ГБУЗ «Центр специализированных видов медицинской помощи Калининградской области»
Russian Federation
Russian Federation
6, Barnaulskaya street, Kaliningrad 236006
Yu. E. Borovikov
Kaliningrad Regional Center of Specialized Types of Medical Care
Russian Federation
Russian Federation
6, Barnaulskaya street, Kaliningrad 236006
T. G. Zadorkina
Kaliningrad Regional Center of Specialized Types of Medical Care
Russian Federation
Russian Federation
6, Barnaulskaya street, Kaliningrad 2360066
P. V. Nekrasova
T.Marciniak Hospital Energency Medicine Center
Poland
Poland
2, General August Emil Fieldorfa street, Wroclaw 54-049
References
1. Korotaeva TV, Korsakova YuL. Psoriatic arthritis: classification, clinical picture, diagnosis, treatment. Nauchno-prakticheskaya revmatologiya. 2018;56(1):650-9. (In Russ.).
2. Ritchlin C, Colbert R, Gladman D. Psoriatic Arthritis. N Engl J Med. 2017 Mar 9;376(10): 957-70. doi: 10.1056/NEJMra1505557.
3. Hoekstra A, Naher H, Lorenz HM. Psoriatic arthritis: a review. J Dtsch Dermatol Ges. 2010 May;8(5):332-9. doi: 10.1111/j.1610-0387. 2009.07334.x. Epub 2009 Dec 11.
4. Mease PJ, Rahman P, Gottlieb A, et al. Guselkumab in biologic-naїve patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet. 2020 Apr 4;395(10230):1126-36. doi: 10.1016/S0140-6736(20)30263-4. Epub 2020 Mar 13.
5. Megna M, Fabbrocini G, Cinelli E, et al. Guselkumab in moderate to severe psoriasis in routine clinical care; an Italian44-week real-life experience. J Dermatolog Treat. 2020 Aug 4;1-5. doi: 10.1080/09546634.2020.1800577. Online ahead of print.
6. Taylor WJ, Gladman DD, Helliwell PS et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006 Aug;54(8): 2665-73. doi: 10.1002/art.21972.
7. Gladman DD, Helliwell P, Mease PJ, et al. Assessment of Patients With Psoriatic Arthritis. Arthritis Rheum. 2004 Jan;50(1):24-35. doi: 10.1002/art.11417.
8. Machado P, Landewe R, Lie E, et al. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis. 2011 Jan;70(1):47-53. doi: 10.1136/ ard.2010.138594. Epub 2010 Nov 10.
9. Machado PM, Landewe R, van der Heijde D. Assessment of SpondyloArthritis international S. Ankylosing Spondylitis Disease Activity Score (ASDAS): 2018 update of the nomenclature for disease activity states. Ann Rheum Dis. 2018 Oct;77(10):1539-40. doi: 10.1136/annrheumdis2018-213184. Epub 2018 Feb 16.
10. Garret SL, Jenkinson TR, Whitelock HC, et al. A new approach to defining disease status in ankylosing spondylitis: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). J Rheumatol. 1994 Dec;21(12):2286-91.
11. Schoels MM, Aletaha D, Alasti F, et al. Disease activity in psoriatic arthritis (PsA): defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016 May; 75(5):811-8. doi: 10.1136/annrheumdis-2015-207507. Epub 2015 Aug 12.
12. Fredriksson T, Pettersson U. Severe psoriasis oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-44. doi: 10.1159/000250839.
13. Yang K, Oak ASW, Elewski BE. use of Il-23 Inhibitors for the treatment of plaque psoriasis and psoriathic arthritis: a comprehensive review. Am J Clin Dermatol. 2021 Mar;22(2):173-92. doi: 10.1007/s40257-020-00578-0.
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For citations:
Nekrasova NV, Borovikov YE, Zadorkina TG, Nekrasova PV. The use of guselkumab in psoriatic arthritis: evidence from real clinical practice. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2021;15(6):91-94. (In Russ.) https://doi.org/10.14412/1996-7012-2021-6-91-94
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