Persistence and Effectiveness Across PsA Patient Subgroups with Guselkumab and IL-17 Inhibitors: 6-Month Results of the Psabiond Observational Study

Objectives Randomized controlled trials demonstrated the efficacy of IL-23 inhibitors (i) and IL-17i in PsA; however, real-world data on their effectiveness in heterogeneous patient subgroups are limited. Some subgroups, such as older, obese, or biologic-experienced patients, are of particular interest as they report worse outcomes.[1] The objective was to assess the 6-month persistence and effectiveness of guselkumab (GUS) and IL-17i across these subgroups of interest. Methods PsABIOnd ( NCT05049798 ) is a global observational study in patients with PsA starting GUS or IL17i as 1st-to-4th line of biologic therapy per their standard of care.[2] The full population of the PsABIOnd study over 6 months of follow up was analyzed. Analyses were performed according to initial treatment group allocation in the overall population and in specific subgroups defined by baseline (BL) age, sex, BMI categories, and prior biologic use. Persistence on treatment (ie, no stop/switch) over 6 months was assessed via the Kaplan-Meier estimator function. Propensity score (PS) analysis was used to evaluate hazard ratio (HR) of GUS vs IL-17i stop/switch prior to the 6-month visit, adjusting for BL variable imbalances across cohorts. Effectiveness was descriptively assessed using rates and means at BL and 6 months of the following measures: swollen and tender joint counts, clinical Disease Activity Index for PsA -based low disease activity /remission, the Leeds Enthesitis Index, psoriasis body surface area, Dermatology Life Quality Index and number of nails affected by psoriatic disease. Dactylitis was not assessed due to the low prevalence of dactylitis at BL. Results Of the 1134 pts analyzed, 555 and 579 pts received GUS or IL-17i, respectively, as their initial treatment. At BL, the GUS/IL-17i cohorts were generally well balanced across subgroups of interest: 83.4%/81.3% were <65 years of age; 60.4%/59.2% were female; 48.0%/43.4% had BMI≥30 kg/m2; and 63.4%/62.3% had previously received ≥1 targeted therapy. Persistence on treatment was high in both cohorts, with 526/555 (94.8%) GUS and 539/579 (93.1%) IL-17i pts remaining on their initial treatment at the 6-month visit (PS-adjusted HR of GUS vs IL-17i stop/switch [95% confidence interval]: 0.93 [0.75-1.16]); (Figure 1). Across patient subgroups of interest, similar improvements in joint symptoms enthesitis skin involvement, and psoriatic nail disease were observed with GUS and IL-17i at the 6-month visit. Conclusion Treatment with GUS or IL-17i resulted in comparable treatment persistence and effectiveness, regardless of age, sex, BMI, or treatment history, through 6 months. These results support the real-world effectiveness of GUS and IL-17i across PsA subpopulations. References [1.] Haddad A. Semin Arthritis Rheum 2025;152737. [2.] Siebert S. Rheumatol Ther 2023;10:489.