gms | German Medical Science

Introduction: GRAPPA and EULAR recommendations highlight the importance of individualised psoriatic arthritis (PsA) treatment and suggest treatment target should be clinical remission (REM) or low/minimal disease activity (LDA/MDA) across key PsA domains [1], [2]. Disease Activity index for Psoriatic Arthritis (DAPSA) and MDA are recommended instruments to assess target status [3]. Ixekizumab (IXE) is a high-affinity monoclonal antibody that selectively targets Interleukin-17A. PRO-SPIRIT is the first large-sample multi-national prospective observational PsA study including IXE. Three-month descriptive data are reported elsewhere [4].

Objective: To report the effectiveness of IXE and other bDMARDs for PsA patients at 12-months based on PRO-SPIRIT real-world evidence.

Methods: Adults with PsA who initiated or switched to new b/tsDMARDs were evaluated across 5 European countries and Canada. This interim analysis focuses on 12-month descriptive data for IXE versus (vs) other bDMARDs within different classes*. Missing values were imputed.

Results: Analysis includes 870 of 1,192 PRO-SPIRIT patients. At baseline, IXE patients had longer disease duration and higher prior b/tsDMARD failures (IXE 70.3% vs TNFi 31.4%), monotherapy rates, and ≥3% BSA involvement vs TNFi patients (Table 1 [Tab. 1]). At 12-months, IXE joint effectiveness and composite outcomes were comparable to TNFi (TJC -5.5 vs -6.3, SJC -3.1 vs -3.5, cDAPSA LDA 31.8% vs 36.8%, cDAPSA REM 19.3% vs 22.1%, MDA 26.5% vs 33.3%), with better skin outcomes (BSA <3% 24.2% vs 14.9%). Baseline characteristics of IL-12/23i and IL-23i were comparable to IXE, except a higher percentage of IL-12/23i patients with MDA (14.7% vs 4.7%). At 12-months, IL-12/23i patients reported reduced TJC (-3.6) and REM (12.0%), and IL-23i patients reported reduced SJC (-2.0), REM (11.9%), and MDA (16.7%) vs IXE.

Conclusion: Despite a higher proportion of patients with previous treatment failures, IXE demonstrated similar joint effectiveness and greater skin improvement than TNFi. Joint effectiveness of IXE was numerically better than IL-12/23i and IL-23i. Results align with 3-month analyses [4] and demonstrate sustained improvements across domains with IXE up to 12-months.

Disclosures: Rieke Alten received payment or honoraria for speakers bureaus from AbbVie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Eli Lilly and Company, Mylan/Viatris, Novartis, Pfizer, Roche, and UCB, consulting fees from AbbVie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Eli Lilly and Company, Mylan/Viatris, Novartis, Pfizer, Roche, and UCB, and support for attending meetings and/or travel from AbbVie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Eli Lilly and Company, Mylan/Viatris, Novartis, Pfizer, Roche, and UCB. Klaus Krüger received payment or honoraria from Eli Lilly and Company and consulting fees from Eli Lilly and Company. Stephanie Werner’s institution received consulting fees from Abbvie, Fresenius, Janssen-Cilag, Johnson & Johnson, Lilly, Novartis, and UCB; and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Abbvie, Fresenius, Janssen-Cilag, Johnson & Johnson, Lilly, Novartis, UCB, and Rheuma-Zentrum Rhein Ruhr. Hagen Russ is a shareholder and an employee of Eli Lilly and Company. Khai Jing Ng is a minor shareholder and an employee of Eli Lilly and Company. Marcus Ngantcha is an employee of Eli Lilly and Company. Angela Kill is a shareholder and an employee of Eli Lilly and Company. Eva Christina Schwaneck received grants from Medac and Fresenius; consultation fees from Takeda, Medac, Amgen, and Galapagos; support for travel or attending meetings from Janssen, UCB, Medac, Abbvie, Takeda, and Otsuka; and, participated on a data safety monitoring or advisory board for Amgen, Galapagos, and Abbvie. Lars Erik Kristensen received fees for speaking from Pfizer, AbbVie, Amgen, UCB, Celgene, BMS, Sanofi, Biogen, Forward Pharma, MSD, Novartis, Eli Lilly and Company, and Janssen pharmaceuticals

*Analyses within Interleukin-17A class (secukinumab) submitted in another abstract.