E152 Guselkumab and IL-17 inhibitors show comparable treatment persistence and effectiveness in psoriatic arthritis: 12-month results of the PsABIOnd observational study

Abstract Background/Aims While randomised controlled trials (RCTs) in psoriatic arthritis (PsA) show early and durable efficacy of IL-23 inhibitors (i) and IL-17i, real-world data are limited. Previous interim analysis of the PsABIOnd study showed similar 6-month guselkumab (GUS) and IL-17i persistence and effectiveness across PsA domains. This analysis aimed to assess 12-month treatment persistence and effectiveness. Methods PsABIOnd (NCT05049798) is an ongoing global observational study in participants with PsA starting GUS or IL17i as 1st-to-4th line of biologic therapy per standard of care. The primary outcome is treatment persistence at 36 months. In this interim analysis, PsABIOnd participants who had a baseline and ≥1 follow-up assessment up until the 12-month visit (±3 months) were analysed according to their initial treatment, regardless of later switches. Treatment persistence (i.e., no stop/switch) for the overall population and by subgroups of interest (prior biologic experience, biological sex) was assessed over 12 months via Kaplan-Meier estimator function. Propensity score (PS) analysis was used to evaluate hazard ratio (HR) of stopping/switching GUS vs IL-17i prior to the 12-month visit, adjusting for baseline variable imbalances across cohorts. Rates of achievement of clinical Disease Activity Index for PsA (cDAPSA) based minimal clinically important improvement (MCII; improvement by ≥ 5.7), low disease activity (LDA)/remission (REM; ≤13), and REM (≤4), minimal disease activity (MDA), psoriasis body surface area (BSA)3%, and Dermatology Life Quality Index (DLQI; ≥4) at the 12-month visit were assessed. Results A total of 511 and 504 participants received GUS or IL-17i, respectively, as their initial treatment. Mean age (53.0/53.7 years) and prior targeted therapy use (not GUS/IL-17i; 62.6%/62.9%) were comparable across GUS/IL17i cohorts at baseline. Treatment persistence up to the 12-month visit was high in both cohorts, with 407/511 (79.6%) GUS and 417/504 (82.7%) IL-17i cohort participants remaining on their initial treatment line (PS-adjusted HR GUS vs IL-17i stop/switch 95% confidence interval: 1.11 0.85-1.44). Reasons for initial treatment line discontinuation were generally consistent across groups. Persistence on GUS and IL-17i remained comparable across prior biologic experience and biological sex subgroups. Improvements in joint, skin, and overall disease activity at 12 months were also similar with GUS and IL-17i. Conclusion Participants with PsA had similar 12-month treatment persistence and rates of effectiveness across key PsA domains with GUS or IL-17i, overall and across subgroups of interest. These results add to real-world evidence of the long-term effectiveness of GUS and IL-17i, supporting efficacy data from RTCs. Disclosure S. Siebert: Consultancies; Abbvie, Amgen, Astrazeneca, Johnson AbbVie, Amgen, AstraZeneca, Johnson AbbVie, Amgen, Johnson Eli Lilly, GSK, Johnson Johnson Johnson Abbvie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Genzyme, Gilead, Johnson Abbvie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Genzyme, Gilead, Johnson Celgene, Chugai, Johnson Abbvie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Johnson Johnson Meeting attendance/travel support: Johnson AbbVie, Amgen, Asahi-Kasei Pharma, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Johnson AbbVie, Amgen, Asahi-Kasei Pharma, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Johnson AbbVie, Johnson AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Johnson AbbVie, Johnson JSS Medical Research. Consultancies; Johnson IQVIA. Consultancies; Johnson Johnson Johnson Former employee of Johnson Johnson AbbVie, Amgen, Celgene, Johnson AbbVie, Amgen, Celgene, Johnson AbbVie, Johnson AbbVie, Amgen, Eli Lilly, GSK, Johnson Abbvie, Gilead, Galapagos, Eli Lilly, Johnson Abbvie, Gilead, Galapagos, Eli Lilly, Johnson Abbvie, Gilead, Galapagos, Eli Lilly, Johnson AbbVie, AlfaSigma, Amgen, Bristol Myers Squibb, Celltrion, Johnson AbbVie, AlfaSigma, Amgen, Bristol Myers Squibb, Celltrion, Johnson AbbVie, Biogen, Eli Lilly, Novartis, UCB.