(242) Treatment patterns and outcomes of Acthar Gel in ankylosing spondylitis and psoriatic arthritis: A physician-reported chart review

Background: : The prevalence for ankylosing spondylitis (AS) has been estimated to be ranging from 0.2 and 1% within the US, while approximately 64 per 100,000 adults are diagnosed with psoriatic arthritis (PsA). Patients are typically managed with biologics, nonbiological disease-modifying antirheumatic drugs (DMARDs), and nonsteroidal anti-inflammatory drugs (NSAIDs). Acthar Gel is a naturally sourced complex mixture of adrenocorticotropic hormone analogs and other pituitary peptides. Acthar Gel is approved by the U.S. Food and Drug Administration (FDA) for the treatment of several autoimmune inflammatory disorders, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA).

Objective: : To describe the characteristics of patients with AS or PsA treated with Acthar Gel, medication utilization, and physicians’ assessments of the effects of Acthar Gel on patients’ health status.

Methods: : A prospectively designed, cross-sectional, medical chart review study with a predefined protocol and analysis plan was conducted in November 2024, with data abstracted from patient records between April 2022 and November 2024. Eligible patients were aged ≥18 years, had AS or PsA, and had received Acthar Gel within ≤24 months.

Results: : On average, patients with AS were 44 years, and with PsA were 51 years; primarily Caucasian/non-Hispanic. Most patients with AS were male (67%, 42/63), whereas PsA had a similar gender distribution (49% [38/77] each). Common comorbidities included arthritis/osteoarthritis, chronic joint disease, and hypertension. Before receiving Acthar Gel, physicians reported 41% (26/63) of patients with AS and 44% (34/77) with PsA had fair-to-poor health status. Frequent symptoms in AS were back pain, lower back/hip stiffness, and fatigue, and in PsA were joint swelling and pain, reduced range of motion, and fatigue. Based on physician assessment, 95% (60/63) with AS and 88% (68/77) with PsA had improved health after Acthar Gel treatment. Improvements included reduction in overall symptoms (AS: 70% [42/60]; PsA: 63% [43/68]), decreased pain (AS: 68% [41/60]; PsA: 62% [42/68]), improved physical function (AS: 53% [32/60]; PsA: 54% [37/68], improved fatigue (AS: 35% [21/60]; PsA: 32% [22/68]), and reduced corticosteroid use (AS: 30% [18/60]; PsA: 31% [21/68]).

Conclusions: : Findings of this chart review reinforce Acthar Gel as an important treatment option for appropriate patients with AS or PsA. A majority of patients evaluated experienced a reduction in overall symptoms, decreased pain, improved physical function, improved fatigue, and reduced corticosteroid use.

Sponsorship:: Mallinckrodt Pharma