BACKGROUND

Psoriatic arthritis (PsA) is an autoimmune disease – a rare form of inflammatory arthritis with variety of symptoms, which imposes a considerable economic burden to patients and society. A growing range of new medicines is extremely helpful in controlling condition. However, the costs of therapy remain substantial.

OBJECTIVES

To evaluate and compare NNTs for achieving ACR50 and PASI 75 and costs per responder (CpR) for biologics (adalimumab, golimumab, guselkumab, ixekizumab, infliximab, netakimab, secukinumab, ustekinumab, certolizumab pegol, etanercept) and targeted synthetic drugs (apremilast, tofacitinib) approved in Russia to treat adults with active PsA.

METHODS

16-week NNTs were calculated as the inverse of risk difference between active treatment and placebo based on the previously published results of a systematic review and network meta-analysis. CpR values were calculated for 16-weeks and one-year treatment periods. The upper limits of 95% credible intervals for NNT and CpR values were used for interpretation and conclusions.

RESULTS

For ACR50, the lowest NNT was demonstrated by netakimab (up to 5 patients) followed by etanercept 25 mg and infliximab (up to 7 patients), the highest – by guselkumab (more than 23 patients). For PASI 75, infliximab was on top with NNT up to 4 patients followed by netakimab (up to 5 patients) while etanercept 25 mg was rank as the last (more than 96 patients). Netakimab showed the lowest CpR for both outcomes followed by etanercept 25 mg in ACR50 and infliximab in PASI 75 respectively. The highest CpR in achieving ACR50 was attributed to guselkumab, PASI 75 – etanercept 25 mg.

CONCLUSIONS

An individual approach based on patient profile and features of certain biologics and targeted synthetic drugs is required in choosing treatment strategy.