EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update.

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Abstract

To update the European League Against Rheumatism (EULAR) recommendations for the pharmacological treatment of psoriatic arthritis (PsA).

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Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis.

Laura Coates, Arthur Kavanaugh, Philip J. Mease … (2016)

To update the 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for the spectrum of manifestations affecting patients with psoriatic arthritis (PsA).

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Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials

Andrew Blauvelt, Kenneth B Gordon, Bruce Strober … (2018)

Risankizumab is a humanised IgG1 monoclonal antibody that binds to the p19 subunit of interleukin-23, inhibiting this key cytokine and its role in psoriatic inflammation. We aimed to assess the efficacy and safety of risankizumab compared with placebo or ustekinumab in patients with moderate-to-severe chronic plaque psoriasis.

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Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial

Christopher Ritchlin, Proton Rahman, Arthur Kavanaugh … (2014)

Objective Assess ustekinumab efficacy (week 24/week 52) and safety (week 16/week 24/week 60) in patients with active psoriatic arthritis (PsA) despite treatment with conventional and/or biological anti-tumour necrosis factor (TNF) agents. Methods In this phase 3, multicentre, placebo-controlled trial, 312 adults with active PsA were randomised (stratified by site, weight (≤100 kg/>100 kg), methotrexate use) to ustekinumab 45 mg or 90 mg at week 0, week 4, q12 weeks or placebo at week 0, week 4, week 16 and crossover to ustekinumab 45 mg at week 24, week 28 and week 40. At week 16, patients with <5% improvement in tender/swollen joint counts entered blinded early escape (placebo→45 mg, 45 mg→90 mg, 90 mg→90 mg). The primary endpoint was ≥20% improvement in American College of Rheumatology (ACR20) criteria at week 24. Secondary endpoints included week 24 Health Assessment Questionnaire-Disability Index (HAQ-DI) improvement, ACR50, ACR70 and ≥75% improvement in Psoriasis Area and Severity Index (PASI75). Efficacy was assessed in all patients, anti-TNF-naïve (n=132) patients and anti-TNF-experienced (n=180) patients. Results More ustekinumab-treated (43.8% combined) than placebo-treated (20.2%) patients achieved ACR20 at week 24 (p<0.001). Significant treatment differences were observed for week 24 HAQ-DI improvement (p<0.001), ACR50 (p≤0.05) and PASI75 (p<0.001); all benefits were sustained through week 52. Among patients previously treated with ≥1 TNF inhibitor, sustained ustekinumab efficacy was also observed (week 24 combined vs placebo: ACR20 35.6% vs 14.5%, PASI75 47.1% vs 2.0%, median HAQ-DI change −0.13 vs 0.0; week 52 ustekinumab-treated: ACR20 38.9%, PASI75 43.4%, median HAQ-DI change −0.13). No unexpected adverse events were observed through week 60. Conclusions The interleukin-12/23 inhibitor ustekinumab (45/90 mg q12 weeks) yielded significant and sustained improvements in PsA signs/symptoms in a diverse population of patients with active PsA, including anti-TNF-experienced PsA patients.

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Journal

Journal ID (iso-abbrev): Ann Rheum Dis

Title: Annals of the rheumatic diseases

Publisher: BMJ

ISSN (Electronic): 1468-2060

ISSN (Print): 0003-4967

Publication date (Electronic): June 2020

Volume: 79

Issue: 6

Affiliations

[1 ] Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France laure.gossec@gmail.com.

[2 ] APHP.Sorbonne Universite, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France.

[3 ] Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Herne, Germany.

[4 ] Division of Rheumatology, Department of Medicine 3; 2nd Department of Medicine, Hietzing Hospital, Medical University of Vienna, Vienna, Austria.

[5 ] EULAR, Zurich, Switzerland.

[6 ] Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.

[7 ] Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France.

[8 ] Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.

[9 ] Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

[10 ] LTHT, Leeds NIHR Biomedical Research Centre, Leeds, UK.

[11 ] Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

[12 ] Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.

[13 ] Research Center of Rheumatic Diseases, Sf Maria Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

[14 ] 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.

[15 ] Patient Research Partner, EULAR, Oslo, Norway.

[16 ] Dermatology, University Hospitals of Geneva, Geneva, Switzerland.

[17 ] Rheumatology and Clinical Immunology, Charite University Hospital Berlin, Berlin, Germany.

[18 ] Arthritis Unit, Department of Rheumatology and IDIBAPS, Hospital Clinic, Barcelona, Spain.

[19 ] Institute of Rheumatology, Belgrade University School of Medicine, Belgrade, Serbia.

[20 ] Department of Biomedicine, Aarhus University, Aarhus C, Denmark.

[21 ] Department of Rheumatology, Aarhus Universitetshospital, Aarhus, Denmark.

[22 ] Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

[23 ] Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands.

[24 ] Rheumatology, Zuyderland MC, Heerlen, The Netherlands.

[25 ] Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Flanders, Belgium.

[26 ] Rheumatology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium.

[27 ] Department of Rheumatology, Infectious Diseases and Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.

[28 ] Epidemiology, German Rheumatism Research Center Berlin, Berlin, Germany.

[29 ] Rheumatology, Hospital de Egas Moniz, Lisboa, Portugal.

[30 ] Universidade Nova de Lisboa Centro de Estudos de Doencas Cronicas, Lisboa, Portugal.

[31 ] Internal Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.

[32 ] Centre for Arthritis and Rheumatic Disease, Dublin Academic Medical Centre, St Vincent's University Hospital, Dublin, Ireland.

[33 ] Department of Internal Medicine and Pediatrics, VIB Center for Inflammation Research, Ghent University, Gent, Belgium.

[34 ] Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

[35 ] Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Wien, Austria.

[36 ] 2nd Department of Medicine, Hietzing Hospital, Vienna, Wien, Austria.

Article

Publisher Item ID: annrheumdis-2020-217159

DOI: 10.1136/annrheumdis-2020-217159

PMC ID: 7286048

PubMed ID: 32434812

SO-VID: b1914a78-be5f-483e-bde0-029f634e1e2d

History

Keywords: treatment,psoriatic arthritis,DMARDs (biologic)

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Keywords: treatment, psoriatic arthritis, DMARDs (biologic)

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EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update.

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Most cited references 73

Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis.

Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials

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