A newly published network meta-analysis (NMA) found Tremfya ranked highest for overall level of skin clearance and provided positive joint efficacy among active psoriatic arthritis therapies.

The NMA concluded Tremfya ranked highest for skin clearance based on Psoriasis (PsO) Area Severity Index (PASI) 90 response among 23 treatment regimens (15 unique treatments including IL-23 inhibitors like Tremfya and risankizumab, subcutaneous [SC] tumor necrosis factor inhibitors [TNFi], and Janus kinase inhibitors [JAKi]). In terms of joint inflammation improvement, both Tremfya dosing regimens (100 mg every four weeks [q4w] and every eight weeks [q8w]) were comparable to most other treatments for the modified van der Heijde-Sharp (vdH-S) score, and Tremfya was generally comparable to TNFi and most IL-17Ai for American College of Rheumatology (ACR) 20 response.

The analysis also confirmed the established safety profile of Tremfya in active PsA. The NMA is being presented at the Maui Dermatology 2022 Meeting taking place January 24-28, 2022. Tremfya is FDA approved for administration as a 100 mg SC injection q8w, following two initial doses at weeks 0 and 4.2.

NMA is a structured, protocol-driven analytical process widely accepted and utilized by regulatory agencies, health technology assessment agencies and medical guideline committees to comparatively evaluate treatment options where head-to-head data are limited or unavailable. NMA is the most cited and the most comprehensive method available to compare studies indirectly; however, NMAs cannot replace and should not be considered the same as head-to-head clinical trials. In this NMA, the timing of primary endpoint assessment varied across RCTs, and placebo was used as the reference treatment throughout with the exception of two head-to-head studies. Baseline risk adjustment was used to account for heterogeneity across study populations. The NMA builds on previous analyses, including a 2021 publication in Rheumatology, and now incorporates all recent clinical data updates, including the COSMOS study of Temfya in PsA patients who had an inadequate response to TNFi, as well as data for two new comparators, the IL-23i risankizumab and the JAKi upadacitinib.

NMA results showed:

• Skin Clearance: Tremfya ranked first and second in PASI 90 response for q4wd and q8w dosing, respectively.
• Joint Inflammation Improvement: Tremfya was comparable to SC TNFi and most IL-17Ai, as measured by ACR20 response. While dosing frequency impacted modified vdH-S score, both Tremfya dosing regimens achieved improvements that were comparable to most treatments and both doses of Tremfya ranked more highly on vdH-S score than risankizumab and upadacitinib.
• Low Numbers of Serious Adverse Events (SAEs): Tremfya showed low rates of SAEs, with both dosing regimens ranking favorably among the 23 treatments for low rates of events. The number of SAEs for Tremfya were consistent with the established Tremfya safety profile.

See-Mease, P., et al. "Comparative Effectiveness of Guselkumab in Psoriatic Arthritis: Updates to a Systematic Literature Review and Network Meta-Analysis". Presented at Maui Derm, January 24-26, 2022.