Golimumab Effective Long-Term Treatment for Psoriatic Arthritis

Psoriatic arthritis (PsA) patients treated with golimumab demonstrated better long term functional improvement, patient global assessment, and radiographpic outcomes when the patients achieved persistent minimal disease activity (MDA), according to a study published in Arthritis Care & Research.

Researchers from all over the globe included PsA patients in the GO REVEAL trial in order to evaluate long term outcomes for PsA patients who did or did not achieve MDA throughout 5 years of treatment with golimumab.

“The GO REVEAL study was a pivotal study initiated by the company to support the registration of golimumab for PsA,” study corresponding author Arthur Kavanaugh, MD, explained to MD Magazine. “Fortunately, they had the foresight and good will to run the study for 5 years. This allowed us to ask interesting related questions about the disease and its treatment.”

MDA response was significantly higher for patients treated with golimumab versus patients randomized to receive placebo treatment through week 14 (23.5 percent vs. 1.0 percent, respectively). This was true for patients treated with golimumab compared to those receiving placebo through week 24 (28.1 percent vs. 7.7 percent, respectively), and golimumab patients compared to placebo at week 52 patients (42.4 percent vs. 30.2 percent, respectively). Half of the golimumab patients reached MDA at least once.

“In this case, patients who had persistently good control of their disease did better over time,” Kavanaugh continued.

At either 3 or fewer or 4 or fewer visits, achievement of MDA was linked to less radiographic progression and more improvement in MDA components. This allowed for further measures of physical function, which the researchers measured using the Health Assessment Questionnaire Disability Index, and overall disease activity at week 256 versus patients not achieving MDA.

“Physicians should strive to achieve the lowest disease activity level for their patients with PsA,” study contributor Dafna D. Gladman, MD, FRCPC told MD Magazine in an e-mail. “If we treat patients earlier and better, patients would fare better.”

Kavanaugh concluded by stressing that this study reinforces the idea of treating to target.