Treatment with guselkumab (Tremfya, Johnson & Johnson) showed early clinical improvements by week 8 in adult patients with active psoriatic arthritis (PsA) for most measures, including joint and skin disease, enthesitis, and dactylitis. These improvements were associated with a meaningful increase in health-related quality of life (HRQoL) from year 1 (week 52) through year 2 (week 100) in a post-hoc analysis of the phase 3 DISCOVER-2 study.
“Patients with active psoriatic arthritis may struggle with engaging in everyday tasks as a result of health-related quality of life symptoms often associated with the disease,” said Philip J. Meased, MD, Swedish Medical Center/Providence St. Joseph Health and University of Washington in Seattle, Washington, in a press release. “In these analyses, we see that achieving early clinical strides in distinct symptom domains may demonstrate future gains in health-related quality of life and fatigue improvement, which underscores the important role this therapy plays in the management of the multiple and complex symptoms of active psoriatic arthritis.”
Guselkumab is a fully human selective interleukin (IL)-23 inhibitor therapy FDA-approved for the treatment of adults with active PsA and with moderate to severe plaque psoriasis. Patients with active PsA must manage physical and mental health challenges caused by the disease that can negatively impact their daily lives. Some patients with PsA also experience fatigue, which is a frequently underreported or underestimated, according to Johnson & Johnson.
A separate post-hoc analysis of the trial found clinically meaningful improvements in fatigue as measured by Functional Assessment of Chronic Illness Therapy-Fatigue. These improvements were observed at 1 year in patients administered guselkumab and were enhanced through 2 years, resulting in greater proportions of patients achieving normative FACIT-F levels.
In DISCOVER-2, biologic-naïve patients with active PsA randomized to guselkumab experienced a response at week 8 in distinct active PsA realms that differentially impacted specific components of HRQoL over 2 years versus placebo. Researchers also observed a statistically significant improvement in overall and physical HRQoL among early clinical responders across several active PsA domains compared with placebo, such as joint and skin disease, enthesitis, and dactylitis.
Although there were differences in HRQoL seen among early clinical responders and non-early responders, the non-early responders experienced a benefit in long-term HRQoL with guselkumab compared with placebo.
Additionally, guselkumab produced a statistically significant benefit vs placebo for lowering fatigue as early as week 8. FACIT-F scores were found to continue improving between week 24 and week 52 in patients administered guselkumab.
These improvements in fatigue observed at week 52 in patients administered guselkumab were further enhanced through week 100, which produced greater proportions of patients achieving normative FACIT-F levels, according to Johnson & Johnson.
“The burden of active psoriatic arthritis on a patient’s quality of life makes the task of effectively managing the debilitating symptoms of this disease all the more urgent and challenging,” said Terence Rooney, MD, vice president, Rheumatology and Maternal-Fetal Immunology Disease Area Leader, Janssen Research & Development, LLC, in a press release. “These analyses from DISCOVER-2 provide patients and physicians with critical insights as they consider the most appropriate treatment option to manage physical symptoms and help improve overall well-being.”