Mease Philip, Korotaeva Tatiana, Shesternya Pavel, Kokhan Muza, Rukavitsyn Anton, Vasilchenkov Dmitry, Sharaf Mohamed, Lavie Frédéric, Deodhar Atul
Department of Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health, and University of Washington, 601 Broadway, Ste 600, Seattle, WA, 98122, USA.
University of Washington, Seattle, WA, USA.
Rheumatol Ther. 2024 Dec;11(6):1551-1567. doi: 10.1007/s40744-024-00713-x. Epub 2024 Sep 25.
There are limited data on the use of advanced therapies to treat psoriatic arthritis (PsA) in Russia. Guselkumab, an interleukin (IL)-23p19-subunit inhibitor, demonstrated efficacy in patients with PsA in the phase 3 DISCOVER-1 and -2, and COSMOS trials. This analysis evaluated the efficacy and safety of guselkumab in patients with PsA in Russia.
This post hoc analysis of DISCOVER-1 and -2 included 1002 biologic-naïve patients with active PsA from Russia (n = 317) and the rest of the world (RoW; n = 685). Patients received guselkumab 100 mg every 4 weeks (Q4W), or at week 0 and 4 then Q8W, or placebo then guselkumab Q4W at week 24 (Russian: n = 119, 88, and 110, respectively; RoW: n = 216, 246, and 223, respectively). Outcomes through week 52 were pooled (DISCOVER-1 and -2); outcomes from week 52 to 100 represent DISCOVER-2 only.
In patients from Russia, ≥ 20% improvement in the American College of Rheumatology (ACR20) criteria response rates were higher with guselkumab vs. placebo at week 24, increased through week 52, and were consistent across all guselkumab-treated groups at week 100. Similar trends were generally observed for ACR50, ≥ 90% improvement in Psoriasis Area and Severity Index (PASI90), achievement of Disease Activity in Psoriatic Arthritis (DAPSA) low disease activity/remission and minimal disease activity, enthesitis and dactylitis resolution, ≥ 0.35 improvement in Health Assessment Questionnaire-Disability Index (HAQ-DI) score, improvement in patient-reported pain, and measures in patients with axial PsA (including Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS], and patient-reported spinal pain). Efficacy responses were similar between patients from Russia and the RoW across all endpoints and timepoints. The safety profile of guselkumab in patients from Russia was consistent with previous findings.
This analysis demonstrated that the safety and efficacy profiles of guselkumab across all PsA domains and patient-reported outcomes in patients from Russia were similar to those in patients from the RoW.
NCT03162796 and NCT03158285.
在俄罗斯,关于使用先进疗法治疗银屑病关节炎(PsA)的数据有限。古塞库单抗是一种白细胞介素(IL)-23p19亚基抑制剂,在3期DISCOVER-1和-2以及COSMOS试验中显示出对PsA患者的疗效。本分析评估了古塞库单抗在俄罗斯PsA患者中的疗效和安全性。
对DISCOVER-1和-2进行的这项事后分析纳入了1002例来自俄罗斯(n = 317)和世界其他地区(RoW;n = 685)的初治生物制剂的活动性PsA患者。患者每4周接受100 mg古塞库单抗(Q4W),或在第0周和第4周接受治疗,然后Q8W,或先接受安慰剂,然后在第24周接受Q4W的古塞库单抗治疗(俄罗斯:分别为n = 119、88和110;RoW:分别为n = 216、246和223)。汇总了至第52周的结果(DISCOVER-1和-2);第52周至100周的结果仅代表DISCOVER-2。
在俄罗斯患者中,与安慰剂相比,古塞库单抗在第24周时美国风湿病学会(ACR20)标准应答率改善≥20%的情况更高,至第52周时有所增加,且在第100周时所有接受古塞库单抗治疗的组中均保持一致。对于ACR50、银屑病面积和严重程度指数改善≥90%(PASI90)、银屑病关节炎疾病活动度(DAPSA)达到低疾病活动度/缓解和最小疾病活动度、附着点炎和指(趾)炎消退、健康评估问卷残疾指数(HAQ-DI)评分改善≥0.35、患者报告的疼痛改善以及轴性PsA患者的测量指标(包括巴斯强直性脊柱炎疾病活动指数[BASDAI]、强直性脊柱炎疾病活动评分[ASDAS]和患者报告的脊柱疼痛),总体上观察到类似趋势。在所有终点和时间点上,俄罗斯患者和RoW患者之间的疗效反应相似。古塞库单抗在俄罗斯患者中的安全性与先前的研究结果一致。
本分析表明,古塞库单抗在俄罗斯患者中所有PsA领域的安全性和疗效概况以及患者报告的结局与RoW患者相似。
NCT03162796和NCT03158285。