AB0921 EFFECTIVENESS OF GUSELKUMAB IN PSORIATIC ARTHRITIS IN DAILY CLINICAL PRACTISE

Abstract

Background Guselkumab is a monoclonal antibody against interleukin-23, biological agent approved for the treatment of plaque psoriasis and psoriatic arthritis. There are two randomised, double-blind, placebo-controlled phase III studies (DISCOVER 1 and DISCOVER 2) that evaluated the efficacy and safety of guselkumab versus placebo. Treatment with guselkumab resulted in significant improvements in the measures of disease activity compared to placebo at Week 24. 1 Objectives To evaluate the response to Guselkumab in patients with Psoriatic Arthritis, according to CASPAR criteria, undergoing treatment by dermatology indication. Methods This is an observational descriptive retrospective study that includes patients with Psoriatic Arthritis (acording to CASPAR criteria) who are being treated with Guselkumab under dermatology indication due to skin involvement. In this study, the epidemiological and clinical characteristics of the patients are assessed: IMC, affected domains, previous treatments, concomitant treatments, PASI before begining the treatment, at 12 week and 24 week, and joint activity mesured by DAPSA at the beggining, after 12 and 24 week. Results There are 7 patients included, 5 women and 2 men, the mean age were 50 ± 7.9 years old, with a BMI (body mass index) average of 33.13 ± 6.26. All the patients presented skin involvement: 4 of 7 with plaque psoriasis (2 of them with scalp psoriasis, and one of those two with inverse psoriasis), 3 of 7 with psoriasis in palms and soles (one with scalp psoriasis and inverse psoriasis), and 2 of 7 pacients with nail involvement. Regarding joint damage, all the patients presented peripheral joint involvement, 2 of 7 with axial too. For the other domains: 2 of 7 have had recurring uveitis, 1 of 7 one episode of dactylitis, and none of them any episode of enthensitis nor inflammatory bowel disease. All the patients had received at least 1 bDMARD (average of 2.8 ± 2.23, but one of them have used 7 before). All the patients received the standard dose of Guselkumab 100mg sc (week 0 and 4) and later each 2 months, with a duration of treatment in months with an average of 6.3 ± 2.88. At the same time, 1 of 7 patient used Methotrexate concomitantly, 2 of 7 with leflunomide, and 1 of 7 with NSAIDs. The PASI average at the beggining of the treatment with Guselkumab was 9.25 ± 4.99, at 12 week all the patients had obtain a PASI 0, and remained in remission. Regarding joint damage measured with DAPSA, at the beggining of Guselkumab treatment the average was 24.15 ± 22.02, at 12 week 12.19 ± 5.56, at the 24 week 8.86 ± 1.6, all of the patients improved, without any inflammatory flares. Any of them presented uveitis, enthensitis nor dactylitis. Drug retention rate of 100%, all the patients are still in treatment with Guselkumab, any side effect was detected. Conclusion Guselkumab is a very effective drug for the treatment of psoriasis, but also for the joint involvement in patients with failure to bDMARD. We need more real life studies to determinate the effectiveness in daily clinical practise. References [1]Guselkumab in patients with active psoriatic arthritis who were biologic-naive or had previously received TNFα inhibitor treatment (DISCOVER-1): a double-blind, randomised, placebo-controlled phase 3 trial Atul Deodhar 1, Philip S Helliwell 2, Wolf-Henning Boehncke 3, Alexa P Kollmeier 4, Elizabeth C Hsia 5, Ramanand A Subramanian 6, Xie L Xu 4, Shihong Sheng 7, Prasheen Agarwal 7, Bei Zhou 7, Yanli Zhuang 8, Christopher T Ritchlin 9, DISCOVER-1 Study Group Lancet 2020 Apr 4;395(10230):1115-1125. doi: 10.1016/S0140-6736(20)30265-8. Epub 2020 Mar 13. [2]Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Philip J Mease 1, Proton Rahman 2, Alice B Gottlieb 3, Alexa P Kollmeier 4, Elizabeth C Hsia 5, Xie L Xu 4, Shihong Sheng 6, Prasheen Agarwal 6, Bei Zhou 6, Yanli Zhuang 7, Désirée van der Heijde 8, Iain B McInnes 9, DISCOVER-2 Study Group Lancet 2020 Apr 4;395(10230):1126-1136. doi: 10.1016/S0140-6736(20)30263-4. Epub 2020 Mar 13. Disclosure of Interests None declared