AB0924 Efficacy of subcutaneous ustekinumab therapy in patients with psoriatic arthritis: a single centre-study
Authors: I. Añón Oñate, I. Notario Ferreira, L. Pérez Albaladejo, M. Á. Ferrer González, M. Ramírez de la Torre, S. Quirosa Flores, A. García Sánchez, M.C. Ramírez Barberena, J.M. Andreu Ubero, R. Cáliz Cáliz
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Ustekinumab is a monoclonal antibody that inhibits IL-12 and 23 that has demonstrated efficacy and safety for the treatment of patients with psoriatic arthritis, plaque psoriasis and Crohn's disease. <h3>Objectives</h3> To evaluate the efficacy of subcutaneous Ustekinumab (USTE) in patients with psoriatic arthritis in a real-world clinical setting in Spain. <h3>Methods</h3> Descriptive, prospective, longitudinal and open study of 66 patients diagnosed with psoriatic arthritis: 63 patients received subcutaneous USTE 45 mg and 3 patients received USTE 90 mg every 12 weeks, both groups received a first dose of induction according to technical specifications. The following variables were collected: age, sex, years of evolution, previous treatment with Synthetic Disease Modifying Anti-Rheumatic Drugs (DMARDs) and/or biologic DMARD, counting of painful and swollen joints, determination of C-reactive protein, presence of dactylitis, onychopathy and cutaneous psoriasis. Clinical efficacy was evaluated by EULAR response criteria and Disease Activity Score (DAS28) according to low activity criteria (DAS28 &gt;2.6–3.2) and remission clinical (DAS28 &lt;2.6) at 6 and 12 months of treatment. Efficacy was compared between 2 subgroups; one group was: patients with USTE monotherapy vs USTE in combination therapy with DMARDs and the other group was: naïve patients vs patients who received previous treatment with biologic DMARD. Enthesis affectation was evaluated with the MASES index. <h3>Results</h3> 66 patients were included, 51.5% were female. The mean age was 47.2±11.3 years and the mean disease duration was 6±7.76 years. USTE was prescribed in 44% as a first line therapy and was administered in combination with DMARDs in 51.5% of the patients (mostly, methotrexate). In our cohort, 74.2% of patients had exclusively peripheral involvement, 10.6% had axial involvement and 15.2% had mixed involvement. 21% of our patients had dactylitis and 36% enthesitis, as well as cutaneous psoriasis (74%) and onicopathy (42%). At 6 and 12 months of treatment, we observed a statistically significant decrease in the count of painful and swollen joints, in the DAS28 index and in the MASES index. DAS28 low disease activity rates were 38% at 6 months and 21% at 12 months of treatment. DAS28 remission rates were 21% and 14% at 6 and 12 months respectively. When comparing efficacy by subgroups, we observed higher EULAR response rates in patients with USTE in combination therapy with DMARDs (figure 1) and biologic DMARD-naïve patients (Figure 2) at 6 and 12 months of treatment. <h3>Conclusions</h3> Ustekinumab is effective for the treatment of psoriatic arthritis and constitutes an alternative to treatment with anti-TNFα. The dose of Ustekinumab 90 mg may improve the response to treatment in some patients, but we would need a greater number of studies in clinical practice. <h3>Disclosure of Interest</h3> None declared