Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis

<strong>Background/objective </strong>The aim of this study was to evaluate relative performance of composite measures in psoriatic arthritis and assess the impact of structural damage and functional disability on outcomes during ixekizumab treatment. <br><strong> Methods <...

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Asıl Yazarlar: Coates, LC, Smolen, JS, Mease, PJ, Husni, ME, Merola, JF, Lespessailles, E, Kishimoto, M, Macpherson, L, Bradley, AJ, Bolce, R, Helliwell, PS
Materyal Türü: Journal article
Dil:English
Baskı/Yayın Bilgisi: BMJ Publishing Group 2022
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author Coates, LC
Smolen, JS
Mease, PJ
Husni, ME
Merola, JF
Lespessailles, E
Kishimoto, M
Macpherson, L
Bradley, AJ
Bolce, R
Helliwell, PS
author_facet Coates, LC
Smolen, JS
Mease, PJ
Husni, ME
Merola, JF
Lespessailles, E
Kishimoto, M
Macpherson, L
Bradley, AJ
Bolce, R
Helliwell, PS
author_sort Coates, LC
collection OXFORD
description <strong>Background/objective </strong>The aim of this study was to evaluate relative performance of composite measures in psoriatic arthritis and assess the impact of structural damage and functional disability on outcomes during ixekizumab treatment. <br><strong> Methods </strong>Data from SPIRIT-P1 and SPIRIT-P2 were analysed to evaluate the effect of ixekizumab on achievement of low disease activity (LDA) and remission with the minimal disease activity (MDA) and very low disease activity (VLDA) composite, Disease Activity index for Psoriatic Arthritis (DAPSA), Psoriatic Arthritis Disease Activity Score, GRAppa Composite ScorE and modified Composite Psoriatic Disease Activity Index (mCPDAI). Performance was compared by quantifying residual symptom burden and the impact of structural damage and functional disability. <br><strong> Results </strong>Significantly more ixekizumab-treated patients achieved treatment targets at week 24 versus placebo assessed with all composites. More patients achieved targets assessed by mCPDAI and DAPSA than other composites. Residual disease activity was similar between composites, but residual high patient-reported outcomes (PROs) and functional disability were more frequent when assessed with mCPDAI and DAPSA. Achievement of treatment targets was reduced by high baseline levels of structural damage and functional disability. <br><strong> Conclusion </strong>Residual disease activity was similar in patients achieving treatment targets assessed with all composites, but residual high PROs and functional disability were more common when assessed with mCPDAI and DAPSA, most likely due to the absence/attenuated functional assessment in these composites. High baseline levels of structural damage and functional disability attenuated response rates with all composites, affecting MDA/VLDA most prominently; LDA may be the most appropriate target in these patients. <br><strong> Trial registration number </strong>NCT01695239.
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spelling oxford-uuid:ca02ab80-25a9-4a26-9136-d9b4ba99ef042022-10-28T14:26:03ZComparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ca02ab80-25a9-4a26-9136-d9b4ba99ef04EnglishSymplectic ElementsBMJ Publishing Group2022Coates, LCSmolen, JSMease, PJHusni, MEMerola, JFLespessailles, EKishimoto, MMacpherson, LBradley, AJBolce, RHelliwell, PS<strong>Background/objective </strong>The aim of this study was to evaluate relative performance of composite measures in psoriatic arthritis and assess the impact of structural damage and functional disability on outcomes during ixekizumab treatment. <br><strong> Methods </strong>Data from SPIRIT-P1 and SPIRIT-P2 were analysed to evaluate the effect of ixekizumab on achievement of low disease activity (LDA) and remission with the minimal disease activity (MDA) and very low disease activity (VLDA) composite, Disease Activity index for Psoriatic Arthritis (DAPSA), Psoriatic Arthritis Disease Activity Score, GRAppa Composite ScorE and modified Composite Psoriatic Disease Activity Index (mCPDAI). Performance was compared by quantifying residual symptom burden and the impact of structural damage and functional disability. <br><strong> Results </strong>Significantly more ixekizumab-treated patients achieved treatment targets at week 24 versus placebo assessed with all composites. More patients achieved targets assessed by mCPDAI and DAPSA than other composites. Residual disease activity was similar between composites, but residual high patient-reported outcomes (PROs) and functional disability were more frequent when assessed with mCPDAI and DAPSA. Achievement of treatment targets was reduced by high baseline levels of structural damage and functional disability. <br><strong> Conclusion </strong>Residual disease activity was similar in patients achieving treatment targets assessed with all composites, but residual high PROs and functional disability were more common when assessed with mCPDAI and DAPSA, most likely due to the absence/attenuated functional assessment in these composites. High baseline levels of structural damage and functional disability attenuated response rates with all composites, affecting MDA/VLDA most prominently; LDA may be the most appropriate target in these patients. <br><strong> Trial registration number </strong>NCT01695239.
spellingShingle Coates, LC
Smolen, JS
Mease, PJ
Husni, ME
Merola, JF
Lespessailles, E
Kishimoto, M
Macpherson, L
Bradley, AJ
Bolce, R
Helliwell, PS
Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title_full Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title_fullStr Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title_full_unstemmed Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title_short Comparative performance of composite measures from two phase III clinical trials of ixekizumab in psoriatic arthritis
title_sort comparative performance of composite measures from two phase iii clinical trials of ixekizumab in psoriatic arthritis
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