EQUATOR analysis shows patient-level response to filgotinib in PsA
medwireNews: Analysis of the EQUATOR trial has shown that patients treated with the Janus kinase (JAK) inhibitor filgotinib for active psoriatic arthritis (PsA) generally achieve a quick response that remains stable over time.
The phase II trial, previously reported by medwireNews, showed a 47% treatment difference in ACR20 response rates between patients randomly assigned to filgotinib 200 mg/day versus placebo for 16 weeks.
Elaborating on this at the EULAR 2019 congress in Madrid, Spain, Philip Mease (University of Washington, Seattle, USA) presented patient-level data looking at the onset and maintenance of this treatment response.
His team found that patients in the filgotinib group achieved an ACR20 response significantly earlier than patients in the placebo group, at a median 4.07 weeks (ranging from 2.29 to 4.14 weeks), compared with 12.29 weeks (ranging from 12.0 to not reached), respectively.
“The patient level response appeared to occur quickly and fewer patients lost response over time in the filgotinib group,” Mease commented.
Indeed, of the patients who had responded to treatment by week 16, significantly more of those with a stable response, regardless of when they first responded, were taking filgotinib, at 80.8% versus 68.2% of the placebo-treated group.
Mease highlighted that significant differences were also seen between filgotinib and placebo in the original trial for ACR50, ACR70, HAQ-DI and PASI75 responses, minimal and low disease activity, pruritus response, and Leeds Enthesitis Index criteria, and for each of these, trends in onset were similar to those seen for ACR20 response.
The safety profile of filgotinib over 16 weeks of treatment was similar to that previously reported for the drug, with no new safety signals.
Mease summarized that “the selective JAK1 inhibitor filgotinib significantly improves multiple domains of psoriatic arthritis,” concluding that “this is a drug that will move forward with further study in PsA.”
When asked about the implications of the analysis, he said that the findings are “useful for the practicing clinician,” by helping set the bar for patient expectation and also “reassure them that if they temporarily lose response that may not be a permanent thing.”
By Lucy Piper
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