Abstract Number: 182

Comparative effectiveness of adalimumab and ustekinumab in patients with psoriatic arthritis

J.L. Wilson ,C. Le Reun , M. Calao

Meeting: 2014 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Introduction: Psoriasis is characterised by skin and often
joint involvement. The anti-IL-12/23 antibody,
ustekinumab, has been available in Australia for the treat-
ment of psoriasis for 3 years. Recently, a study of the safety
and efficacy of ustekinumab in psoriatic arthritis has been
published. No head-to-head trial has compared the efficacy
of TNF blockers vs IL12/23 blockers in treating PsA. The
objective of the current study is to perform an indirect comparison
of the efficacy of adalimumab and ustekinumab for
the treatment of joint symptoms in psoriatic arthritis.
Method: A literature search was performed to identify
appropriate studies. Studies were included if they were
phase 3 placebo controlled studies of at least 24 weeks
duration. The primary efficacy measure was the proportion
of participants with ≥20% decrease in ACR (ACR20) at 24
weeks. ACR20 response rates were summarized as risk
ratios (RRs) and indirectly compared based on the methodology
by Bucher.
Results: Two studies were identified, one for adalimumab
(ADEPT) and one for ustekinumab (PSUMMIT1). Although the majority of baseline characteristics were similar
between the studies, patients included in the adalimumab
study had longer duration of disease while the ustekinumab
study included a higher proportion of patients with BSA
>3%. The indirect comparison demonstrated that patients
treated with adalimumab were significantly more likely to
have an ACR 20 response at week 24 compared with
patients treated with 45 mg or 90 mg ustekinumab (1.98
(1.22, 3.23) and 1.70 (1.05, 2.75) respectively).
Conclusions: The indirect analysis demonstrated that the
anti-TNF antibody, adalimumab, was significantly more
effective at reducing joint symptoms compared with the
anti-IL-12/23 antibody, ustekinumab as measured by ACR20
responses at week 24.