1460: Effect of Guselkumab and IL-17 Inhibitors on Work Productivity and Activity Impairment in Psoriatic Arthritis: 6-Month Results of the PsABIOnd Observational Study

Background/Purpose: Work impairment is a key issue in PsA. Biologic treatments can improve work status in patients (pts) with PsA; however, there is lack of comparative real-world data for different modes of action, e.g. IL-23 and IL-17 inhibitors (i). The current analysis aimed to assess PsA pt-reported outcomes (PRO), specifically work productivity, activity impairment, and disease impact after 6 months of treatment with guselkumab (GUS) and IL-17i.

Methods: PsABIOnd (NCT05049798) is a global (20 countries) observational study in PsA pts starting GUS or IL‑17i as 1st-to-4th line of biologic therapy per standard of care.¹ Here, the full population of the PsABIOnd study was analyzed over the first 6 months of follow-up. Work productivity (overall work productivity loss, absenteeism, presenteeism) and activity impairment were assessed via the Work Productivity and Activity Impairment Questionnaire (WPAI; 0-100).² Pt-reported disease impact was assessed using the PsA Impact of Disease-12 (PsAID‑12; 0-10),³ including the mean total score and proportions of pts achieving minimal clinically important improvement (MCII; improvement by ≥1.4; among pts with BL PsAID-12 score ≥1.4). All analyses were performed according to initial treatment group allocation and treatment comparison was based on 95% confidence intervals (CI).

Results: 1134 pts were analyzed; 555 and 579 received GUS or IL-17i, respectively, as their initial treatment. Mean age (53.2/53.5 yrs), sex (60.4%/59.2% female), and prior exposure to a targeted drug (63.4%/62.3%) were comparable for GUS/IL-17i. Mean overall baseline work productivity loss (42.3%/44.5% for GUS/IL17i groups), absenteeism (14.3%/12.9%), presenteeism (39.2%/42.1%), activity impairment (48.5%/50.6%), and mean baseline PsAID-12 total score (5.1/5.1) were also similar between groups.

At the 6-month visit, comparable improvements were observed in all WPAI outcomes with GUS and IL-17i. Mean (95% CI) improvements in GUS/IL-17i were: overall work productivity loss (-13.1 [-16.5, -9.7]/-13.8 [-17.5, -10.1]%), absenteeism (-6.4 [-10.4, -2.4]/-2.5 [-5.1, 0.2]%), presenteeism (-12.5 [-15.7, -9.3]/-14.0 [-17.5, -10.5]%), activity impairment (-13.1 [-15.4, -10.8]/-15.7 [-18.2, -13.1]%; Fig 1). Mean PsAID-12 total scores also improved significantly (-1.6 [-1.7, -1.4]/-1.8 [-2.0, -1.6]) reaching levels (3.5/3.3) indicative of symptom impact below the pt acceptable symptom state threshold (≤ 4.0) in both groups (Fig 2). Rates of pts achieving PsAID-12 MCII at 6 months were also comparable (54.7%/55.9%).

Conclusion: By 6 months of treatment in real-world, improvements in work productivity and ability to perform daily activities were observed with both GUS and IL-17i which were paralleled with clinically meaningful improvements in pt-reported multidomain disease impact. Based on overlapping CIs, improvements in PROs were comparable between the two modes of action. These results may be useful for reimbursement decisions and healthcare provider/pt shared treatment decision-making.

References
1. Siebert S. Rheumatol Ther. 2023;10(2):489
2. Teilly MC. Parmacoeconomics. 1993; 4(5):353
3. Gossec L. Ann Rheum Dis. 2014;73(6):1012