Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of Dermatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Int J Rheum Dis. 2023 May;26(5):878-884. doi: 10.1111/1756-185X.14663. Epub 2023 Mar 16.
This study aimed to show the effectiveness of interleukin (IL)-23 inhibitors in psoriatic arthritis (PsA) at weeks 12 and 24 in a real-world setting.
Forty-three patients with active PsA were enrolled in this study. These patients were treated with either guselkumab (n = 20) or risankizumab (n = 23). Treatment responses at the 12th and 24th weeks were evaluated with the parameters of the number of joints with active arthritis, Psoriasis Area Severity Index (PASI) response rate, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, Disease Activity Index for Psoriatic Arthritis (DAPSA) score, and C-reactive protein (CRP) value. The study's primary endpoint was BASDAI ≤ 4 and DAPSA ≤ 14 at week 24, and the secondary endpoint was the absence of joints with clinically active arthritis signs at week 24.
IL-23 inhibition significantly improved all treatment response parameters at the 12th and 24th weeks (P < 0.001). While 90% of patients reached the primary endpoint with anti-IL23 therapy, 74% achieved the secondary endpoint. Both biologic-naïve and biologic-experienced patients responded significantly to anti-IL-23 therapy. Also, no adverse events related to anti-IL-23 agents were observed.
The response parameters indicating the severity of PsA (the number of joints with active arthritis, BASDAI score, DAPSA score, and CRP value) and a parameter indicating the severity of skin involvement, that is, PASI score, significantly improved with anti-IL-23 therapy at weeks 12 and 24. Moreover, significant improvement was achieved at week 24 compared to week 12 in all response parameters.
本研究旨在展示白细胞介素（IL）-23 抑制剂在真实环境中治疗银屑病关节炎（PsA）患者在第 12 周和第 24 周的有效性。
本研究纳入了 43 例活动性 PsA 患者。这些患者接受了古塞单抗（n=20）或利纳西单抗（n=23）治疗。在第 12 周和第 24 周，通过评估关节计数、银屑病面积严重程度指数（PASI）应答率、巴斯强直性脊柱炎疾病活动指数（BASDAI）评分、疾病活动度的银屑病关节炎指数（DAPSA）评分和 C 反应蛋白（CRP）值，评估治疗应答。研究的主要终点为第 24 周时 BASDAI≤4 和 DAPSA≤14，次要终点为第 24 周时无临床活动性关节炎迹象的关节。
IL-23 抑制在第 12 周和第 24 周时显著改善了所有治疗应答参数（P<0.001）。抗 IL-23 治疗使 90%的患者达到了主要终点，74%的患者达到了次要终点。生物初治和生物经验丰富的患者对抗 IL-23 治疗均有显著应答。此外，未观察到与抗 IL-23 药物相关的不良反应。
反映 PsA 严重程度的应答参数（有活性关节炎的关节数、BASDAI 评分、DAPSA 评分和 CRP 值）和反映皮肤受累严重程度的参数（即 PASI 评分）在第 12 周和第 24 周时经抗 IL-23 治疗后显著改善。此外，与第 12 周相比，所有应答参数在第 24 周时均有显著改善。
