Background Psoriatic arthritis (APs) is a chronic inflammatory joint disease, that can be treated effectively with synthetic disease modifying anti-rheumatic drugs (DMARDs) and biological agents. Ustekinumab is a monoclonal antibody that inhibits IL-12 and 23 that has recently demonstrated efficacy and safety for the treatment of patients with APs in the PSUMMIT 1 and PSUMMIT 2 studies.
Objectives To evaluate the efficacy of Ustekinumab in our patients with psoriatic arthritis with peripheral involvement in clinical practice conditions.
Methods Descriptive, prospective, longitudinal and open study including patients diagnosed with psoriatic arthritis with peripheral involvement. All patients were given ustekinumab at an initial dose of 45 mg administered subcutaneously followed by another 45 mg dose 4 weeks later and then every 12 weeks. Clinimetric scores (DAS28, MASES, Pain VAS, Clinicians VAS) were assessed and CRP was measured al baseline and after 6 months of treatment.
Results 52 patients were included, 25 were female (48.1%) and 27 male (51.9%). They had a mean age of 46.96±11.39 years, a disease duration of 5.03±5.08 years, and moderate disease activity (DAS 28 of 3.95±0.87), the number of tender and swollen joints were 6.24±4.9 and 2.82±2.36, respectively. The patients had received an average of 1.42±1.75 biological therapies previously. Ustekinumab was prescribed as a first line treatment in 42.3% of patients, 19% after failure of a TNF inhibitor and 38% of patients had received 2 or more biological therapies previously. Ustekinumab was administered alone in 51% of the patients, 36.5% in combination with methotrexate and 11.5% in combination with leflunomide. 23.1% of the patients had dactylitis and 36.5% had enthesitis (mean MASES 1.31±0.86). At 6 months of treatment, there were improvements in the number of tender and swollen joints (mean NAD 4.84±6.4 and NAT 2±3.4 at 6 months, respectively) and MASES index (mean at 6 months, 0.35±0.96). 15 patients had completed at least 6 months of treatment. Improvements in DAS28-CRP scores were observed at 6 months of treatment (3.26±1.62), with a mean DAS28 change after 6 months (ΔDAS28) of -0.65±1.88. At month 6, 71.4% of the patients had low disease activity, and 35.7% were in clinical remission according to the DAS28 index.
Conclusions Ustekinumab is effective in patients with psoriatic arthritis with peripheral involvement in routine clinical practice.
Disclosure of Interest None declared