Work Productivity and General Health Through 2 Years of Guselkumab Treatment in a Phase 3 Randomized Trial of Patients With Active Psoriatic Arthritis

• Published in: Rheumatology and therapy. Vol. 11; no. 2; pp. 425 - 441
• Main Authors: Curtis, Jeffrey R., McInnes, Iain B., Rahman, Proton, Gladman, Dafna D., Peterson, Steven, Yang, Feifei, Adejoro, Oluwakayode, Kollmeier, Alexa P., Shiff, Natalie J., Han, Chenglong, Shawi, May, Tillett, William, Mease, Philip J.
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01-04-2024; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Cost control; Family Medicine; General Practice; Guselkumab; Health-related quality of life; Internal Medicine; Medicine; Medicine & Public Health; Monoclonal antibodies; NCT; NCT03158285; Original Research; Orthopedics; Productivity; Psoriatic arthritis; Quality of Life Research; Rheumatology; Work productivity; Work productivity; Health-related quality of life; Guselkumab; Psoriatic arthritis
• ISSN: 2198-6576; 2198-6584
• DOI: 10.1007/s40744-024-00642-9

Introduction
To evaluate the effect of guselkumab on work productivity and nonwork daily activity impairment and general health status through 2 years in patients who were biologic-naïve with active psoriatic arthritis (PsA) in the phase 3 DISCOVER-2 clinical trial.
Methods
Adult patients with PsA were randomized to subcutaneous injections of guselkumab 100 mg every 4 weeks (Q4W); at weeks 0, 4, then every 8 weeks (Q8W); or placebo (through week 24 with crossover to guselkumab Q4W). Work productivity and nonwork daily activity impairment were assessed using the Work Productivity and Activity Impairment Questionnaire for PsA (WPAI-PsA) and patient-reported general health status using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and EQ-Visual Analog Scale (EQ-VAS). Least-squares (LS) mean changes from baseline in WPAI-PsA domains and EQ-5D-5L/EQ-VAS were assessed through week 100. Changes in employment status were utilized to estimate potential indirect savings from improved work productivity.
Results
Of 739 randomized patients, 738 had available baseline data for the analyses (Q4W 245; Q8W 248; placebo 245). At week 24, greater improvements in work productivity, nonwork daily activity, and EQ-5D-5L/EQ-VAS were observed in the Q4W and Q8W groups versus the placebo group. At week 100, LS mean reductions in work productivity impairment (− 23.8% to − 28.0%) and nonwork daily activity impairment (– 26.6% to − 29.2%) and improvements in EQ-5D-5L/EQ-VAS (0.14 to 0.15/21.2 to 25.0) were maintained in patients receiving guselkumab. Among patients employed at baseline, 12.1–16.4% were not employed at week 100, and 20.0–25.3% shifted from not employed at baseline to employed at week 100. Potential yearly indirect cost savings (USD) from improved work productivity at week 100 ranged from $16,529 to $19,409.
Conclusion
Patients with active PsA treated with guselkumab demonstrated reduced impairment in work productivity and nonwork daily activity, together with improvement in general health status and substantial potential cost savings, over a 2-year period.
Trial Registration
Clinicaltrials.gov identifier: NCT03158285.