Early Adalimumab Leads to Better Outcomes for Patients With Psoriatic Arthritis

In late 2017, a study was published in Acta Reumatologica Portuguesa evaluating the effect of adalimumab (Humira), an anti—tumor necrosis factor therapy, in the treatment of patients with both short- and long-term psoriatic arthritis (PsA) disease duration.

This study was a multicenter, non-interventional, open cohort trial that utilized data from the Rheumatic Diseases Portuguese Register. Patients included in the study were adults with PsA who were diagnosed according to the Classification Criteria for Psoriatic Arthritis, were registered in the database between June 2008 and June 2016, and had received adalimumab therapy for 3 or more months.

In total, 126 patients were included in the study. Participants with early PsA had a mean disease duration of 2.6 years (±1.3 years) and were significantly younger and began treatment with biologics earlier than patients with late PsA. Conversely, patients with late-stage PsA had a mean disease duration of 13.4 years (±8.1 years).

A Psoriasis Arthritis Response Criteria (PsARC) response was achieved by 72.9% of patients treated with adalimumab at 3 months. Of the participants receiving adalimumab at month 24, 85.4% had a PsARC response. More patients with early PsA achieved PsARC at 3 months than did patients with late PsA (88% versus 62.2%; P =.022) and 24 months (100% versus 75.8%; P =.044).

The early PsA group achieved, on average, a PsARC response 3.8 months after initial treatment with adalimumab; the mean time to PsARC response in patients with late PsA was 7.4 months.

It is important to note that, during the study follow-up, 51 patients (37.8%) discontinued treatment with adalimumab. The mean duration of therapy until discontinuation was 25.7 months (± 21.2 months): 14.7 months (±16.5 months) for patients with early PsA and 29.9 months (± 22.6 months) for those with late PsA (P =.033).

The most common reason for therapy discontinuation was lack of efficacy, and the proportion of patients with early PsA (31.7%) and late PsA (40.0%) who discontinued adalimumab was similar.

Researchers found that, in this real-world clinical setting, patients with PsA who had a shorter disease duration achieved better results after treatment with adalimumab than did patients with a longer disease duration. This finding adds support to the idea that shorter symptom duration and earlier treatment with adalimumab could lead to a more favorable outcome in patients with PsA. Researchers did note, however, that further studies are needed to confirm these results.