P172 Quality of life improvements in patients with PsA who achieve remission or low disease activity targets: results from two clinical trials of ixekizumab at three years of treatment

Abstract Background/Aims Treatment guidelines suggest a treat-to-target strategy using remission or low disease activity (LDA) targets in psoriatic arthritis (PsA). For patients with PsA, target achievement is associated with significantly improved quality of life (QoL). This analysis examined physical function and QoL improvements in PsA patients achieving remission or LDA targets at 3 years (156 weeks) of treatment with ixekizumab, a high-affinity monoclonal antibody selectively targeting interleukin-17A. Methods This study used integrated data from 2 double-blind, randomized phase 3 clinical trials (SPIRIT-P1, NCT01695239; SPIRIT-P2, NCT02349295) of ixekizumab-treated PsA patients who entered the extension period (N = 410). QoL outcome measures included HAQ-Disability Index (HAQ-DI), 36-Item Short-Form Health Survey Physical Component Score (SF-36 PCS), and the 5-level EQ-5D Visual Analogue Scale (EQ-5D-5L VAS). Remission or LDA targets included minimal disease activity (MDA), very low disease activity (VLDA), Disease Activity in Psoriatic Arthritis (DAPSA) remission, DAPSA LDA, Psoriatic Arthritis Disease Activity Score (PASDAS) LDA, and PASDAS VLDA. The response rate (%) of patients achieving minimal clinically important differences (MCID RR) for measures with defined MCID and changes from baseline (CFB) for EQ-5D-5L VAS were observed. QoL improvements by remission or LDA target response status were assessed; significance was calculated by Fisher’s exact test for MCID RR and one-way analysis of variance for CFB. Missing data were imputed by non-responder imputation and modified baseline observation carried forward for binary and continuous measures, respectively. Results At 3 years of treatment, the percentage of responders was 34.6% (n/N=142/410), 16.1% (n/N=66/410), 48.8% (n/N=200/410), 23.4% (n/N=96/410), 40.5% (n/N=166/410), and 20.7% (n/N=85/410) for MDA, VLDA, DAPSA LDA, DAPSA remission, PASDAS LDA, and PASDAS VLDA, respectively. Achievement of VLDA, DAPSA remission, and PASDAS VLDA were significantly associated with the most QoL improvement, more than achievement of MDA, DAPSA LDA, and PASDAS LDA, which were significantly associated with more QoL improvement than target nonachievement (Table). P172 Table 1:Association of Patients Achieving Remission or Low Disease Activity Targets with Incremental QoL Improvement at 3 Years.(1) Did not achieve MDA or VLDA(2) MDA but not VLDA(3) Achieved VLDAHAQ-DI MCID RRResponse, % (n/N)16.3 (40/246)83.1 (5