Persistence and Effectiveness of the IL-12/23 Pathway Inhibitor Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: 1-year Results From the Real-world PsABio Study

Ann Rheum Dis 2022 doi: 10.1136/annrheumdis-2021-221640

Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.

This study acted as an update for the PsABio, a prospective, observational study which followed patients with PsA who were prescribed first-line to third line ustekinumab or TNFi. Drug persistence, effectiveness and safety were assessed every 6 months and the collected data analysed to produce PS-adjusted comparisons across cohorts.

These propensity score-adjusted comparisons also found that patients were more likely to remain on ustekinumab than TNFi when extensive skin disease was present and when MTX was not used as a concomitant treatment. This provides an interesting insight into treatment persistence which may be useful to clinicians.