Guselkumab sustains improvements in work productivity and daily activity in patients with active psoriatic arthritis
Presenter: Jeffrey Curtis, MD, University of Alabama at Birmingham, Birmingham, AL
Guselkumab provides sustained improvements in work productivity and daily activity in patients with active psoriatic arthritis through 2 years of DISCOVER-2. Abstract 0509. Presented November 12, 2022.
Guselkumab-treated patients with psoriatic arthritis show sustained improvements in work productivity and daily activity through 2 years.
Psoriatic arthritis (PsA) impacts patients’ work productivity and levels of daily activity. The phase III DISCOVER-2 trial of the selective interleukin-23 p19-subunit inhibitor guselkumab in biologic-naive patients with PsA found significant improvements in patient-reported work productivity for 475 patients employed at baseline and in daily activity levels for 733 patients after 1 year of guselkumab treatment. In the trial, patients with active PsA were randomized to receive guselkumab 100 mg every 4 weeks; guselkumab 100 mg at week 0, week 4, then every 8 weeks; or placebo. At week 24, placebo recipients crossed over to guselkumab 100 mg every 4 weeks.
“We assessed these patients through 2 years, estimating indirect savings associated with guselkumab treatment and assessing changes in employment status,” Curtis said.
The Work Productivity and Activity Impairment (WPAI)-PsA tool was used to assess PsA-related work time missed (absenteeism), impairment while working (presenteeism), and impaired overall work productivity (absenteeism plus presenteeism) for patients employed at baseline. The daily activity level for all patients was also measured, including those unemployed at baseline during the previous week.
Mean changes in WPAI-PsA domains were calculated for each multiple imputation dataset using an analysis of covariance. Among patients employed at baseline, potential indirect savings from improved overall work productivity were estimated using the 2020 European Union mean yearly wage estimate (all occupations) combined with the least square mean change from baseline in WPAI-PsA overall work impairment. A shift analysis evaluated proportions of patients employed versus unemployed by treatment group using observed data over time.
“About half of all patients had missed work due to PsA at baseline and also had their daily activity impaired,” Curtis said. “By week 24, there was a 10% difference in favor of both guselkumab arms in work and daily activity. By week 100, when everyone was on active therapy, about 75% of patients achieved a minimal clinically important difference in work productivity.”
Among the 64% of patients employed at baseline through week 100, 84% continued to work, regardless of the guselkumab dosing regimen. Among 36% unemployed patients at baseline, the proportion of patients working increased by more than 20% during the 2-year course of therapy.
The indirect cost analysis showed that for those making an average salary, at week 100, guselkumab saved employers $16,000 to $19,000 per year, he said.
In conclusion, Curtis said, “In guselkumab-treated bio-naive PsA patients, we saw work productivity and daily activity gains through week 24, separate from placebo, that continued through week 100 of guselkumab treatment. Long-term improvements in work productivity achieved may result in substantial indirect cost savings for guselkumab-treated patients. Employment rates remained generally stable through 2 years in patients who were employed at baseline and increased in those who were unemployed at baseline and treated with guselkumab.”
Curtis noted these patients were quite ill, and therefore the results may not be generalizable.
References
Mease PJ, Rahman P, Gottlieb AB, et al. Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020; 395(10230):1126–1136. doi:10.1016/S0140-6736(20)30263-4
Tillett W, de-Vries C, McHugh NJ. Work disability in psoriatic arthritis: a systematic review. Rheumatology (Oxford) 2012; 51(2):275-283. doi:10.1093/rheumatology/ker216
Organisation for Economic Co-operation and Development (2022). Average wages (indicator). Available at https://data.oecd.org/earnwage/average-wages.htm. Accessed Nov 15, 2022.
Curtis J, McInnes IB, Rahman P, et al. Guselkumab provides sustained improvements in work productivity and daily activity in patients with active psoriatic arthritis through 2 years of DISCOVER-2 [abstract 0509]. Arthritis Rheumatol 2022; 74(suppl 9). https://acrabstracts.org/abstract/guselkumab-provides-sustained-improvements-in-work-productivity-and-daily-activity-in-patients-with-active-psoriatic-arthritis-through-2-years-of-discover-2
Disclosures
Jeffrey Curtis: Amgen, Bristol Myers Squibb, CorEvitas, Illumination Health, Janssen Pharmaceuticals, Elly Lilly and Company, Myriad Genetics, Novartis, Pfizer, Sanofi, UCB, Aqtual, Bendcare, FASTER, GSK, Labcorp, Scipher Medicine, Setpoint Integrated Solutions, United Rheumatology, AbbVie, ArthritisPower.