Abstract
Objectives Work impairment is a key issue in PsA. Biologic treatments can improve work status in patients with PsA; however, there is lack of comparative real-world data for different classes, eg, IL-23 and IL-17 inhibitors(i). The current analysis aimed to assess PsA patient-reported outcomes (PRO), specifically work productivity, activity impairment, and disease impact after 6 months of treatment with guselkumab (GUS) and IL-17i.
Methods PsABIOnd (NCT05049798) is a global observational study in PsA patients starting GUS or IL17i as 1st-to-4th line of biologic therapy per standard of care.[1] Here, the full population of the PsABIOnd study was analyzed over the first 6 months of follow-up. Work productivity and activity impairment were assessed via the Work Productivity and Activity Impairment Questionnaire (WPAI; 0-100).[2] Patient-reported disease impact was assessed using the PsA Impact of Disease-12 (PsAID12; 0-10),[3] including the mean total score and proportions of pts achieving minimal clinically important improvement (MCII); improvement by ≥1.4; among pts with BL PsAID-12 score ≥1.4). All analyses were performed according to initial treatment group allocation, and treatment comparison was based on 95% confidence intervals (CI).
Results 1134 patients were analyzed; 555 and 579 received GUS or IL-17i, respectively, as their initial treatment. Mean age (53.2/53.5 yrs), sex (60.4%/59.2% female), and prior exposure to a targeted drug (63.4%/62.3%) were comparable for GUS/IL-17i. Mean overall baseline work productivity loss (42.3%/44.5% for GUS/IL17i groups), absenteeism (14.3%/12.9%), presenteeism (39.2%/42.1%), activity impairment (48.5%/50.6%), and mean baseline PsAID-12 total score (5.1/5.1) were also similar between groups. At the 6-month visit, comparable improvements were observed in all WPAI outcomes with GUS and IL-17i. Mean (95% CI) improvements in GUS/IL-17i were: overall work productivity loss (−13.1 [−16.5, −9.7]/−13.8 [−17.5, −10.1]%), absenteeism (−6.4 [−10.4, −2.4]/−2.5 [−5.1, 0.2]%), presenteeism (−12.5 [−15.7, −9.3]/−14.0 [−17.5, −10.5]%), activity impairment (−13.1 [−15.4, −10.8]/−15.7 [−18.2, −13.1]%); (Figure 1). Mean PsAID-12 total scores also improved significantly (−1.6 [−1.7, −1.4]/−1.8 [−2.0, −1.6]) reaching levels (3.5/3.3) indicative of symptom impact below the patient acceptable symptom state threshold (≤ 4.0) in both groups. Rates of pts achieving PsAID-12 MCII at 6 months were also comparable (54.7%/55.9%).
Conclusion By 6 months of treatment in real-world, improvements in work productivity and ability to perform daily activities were observed with both GUS and IL-17i, paralleled with clinically meaningful improvements in patient-reported multidomain disease impact. Based on overlapping CIs, improvements in PROs were comparable between the 2 classes. These results may be useful for reimbursement decisions and healthcare provider/patient shared treatment decision-making.
References [1.] Siebert S. Rheumatol Ther 2023;10:489. [2.] Teilly MC. Parmacoeconomics. 1993;4:353. [3.] Gossec L. Ann Rheum Dis 2014;73:1012.
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