Real-World Comparison of On-Label Treatment Persistence Through 24 Months Between Patients with Psoriatic Arthritis Initiating Guselkumab or Subcutaneous Interleukin-17A Inhibitors
Advances in Therapy, 2025
Introduction
Patients with active psoriatic arthritis (PsA) initiating guselkumab are nearly two times more likely to remain persistent with on-label therapy at 12 months compared to those initiating subcutaneous (SC) interleukin-17A inhibitors (IL-17Ai). In this real-world study, on-label treatment persistence at 24 months was compared between patients with active PsA initiating guselkumab versus SC IL-17Ai, overall and among biologic-naïve and biologic-experienced subgroups.
Methods
Adult patients with active PsA initiated on guselkumab or SC IL-17Ai (secukinumab, ixekizumab) between July 14 2020 and December 31 2022 were identified from the IQVIA PharMetrics® Plus database. The first claim defined the index date, and results were stratified based on previous biologic (bDMARD) use. Treatment cohorts were balanced using propensity score overlap weighting. On-label treatment persistence (no treatment discontinuation or dose modification) through 24 months was assessed using weighted Kaplan-Meier curves and compared between cohorts using Cox proportional hazards models.
Results
Overall, 849 patients initiating guselkumab (biologic-naïve: 362, biologic-experienced: 487) and 2601 patients initiating SC IL-17Ai (biologic-naïve: 845, biologic-experienced: 1756) were included. On-label treatment persistence rates at 24 months were 44.9% and 35.0% for patients initiating guselkumab or SC IL-17Ai, respectively, with patients initiating guselkumab being 1.49 times more likely to be persistent with on-label therapy (hazard ratio [95% confidence interval]: 1.49 [1.29, 1.72]; P < 0.001). Results were consistent among biologic-naïve (1.70 [1.32, 2.20]; P < 0.001) and biologic-experienced (1.33 [1.11, 1.59]; P = 0.002) subgroups.
Conclusion
This real-world study identified greater on-label treatment persistence rates at 24 months in patients with active PsA initiating guselkumab versus SC IL-17Ai, overall and among biologic-naïve and biologic-experienced subgroups.
Authors
Mease PJ, Walsh JA, Fitzgerald TP, Chakravarty SD, Adamson E, Emond B, Rossi C, Schwartzbein S, Yokoji K, Wang Y, Lefebvre P, Pilon D, Singla S, Merola JF