This information is intended for US healthcare professionals to access current scientific information about J&J Innovative Medicine products. It is prepared by Medical Information and is not intended for promotional purposes, nor to provide medical advice.
Summary
- The company cannot recommend any practices, procedures, or usage that deviate from the approved labeling.
- Please refer to the local labeling for clinical data on the use of TREMFYA in adult patients with moderate to severe plaque psoriasis (PsO).
- The VOYAGE 2 study, a phase 3, randomized, double-blind, placebo- and active comparator-controlled clinical trial, evaluated the efficacy and safety of TREMFYA in patients with moderate to severe plaque PsO. Analyses from the VOYAGE 2 study in patients with a medical history or current diagnosis of depression were included.1 Data specific to Hospital Anxiety and Depression Scale-Depression (HADS-D) is summarized below.
- An analysis from the VOYAGE 2 study evaluated the improvement in symptoms of anxiety and depression with TREMFYA vs placebo and adalimumab from baseline through week 24 in patients with moderate-to-severe plaque PsO.2
- At weeks 8 and 16, a significantly greater improvement in the HADS-D score was observed in patients treated with TREMFYA vs placebo (P<0.001).
- At week 24, a greater improvement in the HADS-D score was observed in patients treated with TREMFYA vs adalimumab (P=0.06).
- Two additional analyses reported improvement in HADS-D scores from the VOYAGE 2 study.
- Improvement in HADS-D score was observed with continuous treatment with TREMFYA through week 204. At baseline, 27.7% of all patients had depression (HADS-D score of ≥8), and among patients treated with TREMFYA, 16.6% and 21.0% had depression at weeks 100 and 204, respectively.3
- At week 100, 56.8% of patients with a baseline HADS-D score of ≥8 reported an HADS-D score of <8, and the results were maintained through week 252.4
clinical data
VOYAGE 2: Results through Week 24
Gordon et al (2018)2 presented results from the VOYAGE 2 study on improvement in symptoms of anxiety and depression with TREMFYA vs placebo and adalimumab from baseline through week 24 in patients with moderate-to-severe plaque PsO.
Study Design/Methods
- Patients were randomized (2:1:1) to receive TREMFYA (100 mg subcutaneously [SC] at weeks 0, 4, 12, and 20), placebo (at weeks 0, 4, and 12 followed by TREMFYA 100 mg SC at weeks 16 and 20), or adalimumab (80 mg SC at week 0, 40 mg at week 1, and 40 mg every 2 weeks [q2w]) through week 23.
- Hospital Anxiety and Depression Scale (HADS), which consists of 2 subscales measuring patient-reported anxiety (Hospital Anxiety and Depression Scale-Anxiety [HADS-A]) and depression (HADS-D), was used to assess anxiety and depression. The scores range from 0 to 21, with higher scores indicating more severe symptoms.
- Patients with an HADS-D score of ≥8 were identified to have mild symptoms, and those with an HADS-D score of ≥11 were identified to have severe clinical symptoms.
Results
- A total of 992 patients were randomized to each treatment group. The mean HADS-D scores were similar between the treatment groups; see Table: Baseline HADS-D Scores.
- At baseline, 3.7% of patients reported use of antidepressant medication and 2.4% used benzodiazepines.
|
|
|
|
---|
Mean (SD)
| 5.1 (4.3)
| 5.3 (4.2)
| 5.3 (4.3)
|
Score ≥8, n (%)
| 66 (26.6)
| 134 (27.1)
| 74 (30.1)
|
Score ≥11, n (%)
| 36 (14.5)
| 61 (12.3)
| 34 (13.8)
|
Patients with a self-reported medical history of depression, n (%)
| 18 (7.3)
| 38 (7.7)
| 19 (7.7)
|
Abbreviations: HADS-D, Hospital Anxiety and Depression Scale-Depression; SD, standard deviation.
|
- At weeks 8 and 16, a significantly greater improvement in the HADS-D score was observed in patients treated with TREMFYA vs placebo (P<0.001).
- At week 24, a greater improvement in the HADS-D score was observed in patients treated with TREMFYA vs adalimumab (P=0.06); see Table: Change in the HADS-D Scores from Baseline at Weeks 8, 16, and 24.
Change in the HADS-D Scores from Baseline at Weeks 8, 16, and 242
|
|
|
|
---|
Week 8
|
Mean±SD
| 0.0±2.9
| -1.3±3.3
| -1.2±3.0
|
P value vs placebo
| -
| <0.001
| <0.001
|
Week 16
|
Mean±SD
| -0.1±2.9
| -1.6±3.6
| -1.2±3.4
|
P value vs placebo
| -
| <0.001
| <0.001
|
Week 24
|
Mean±SD
| -
| -1.7±3.8
| -1.1±3.5
|
P value vs adalimumab
| -
| 0.06
| -
|
Abbreviations: HADS-D, Hospital Anxiety and Depression Scale-Depression; SD, standard deviation. aPatients who were randomized and had the HADS scores at baseline.
|
HADS-D Scores at Weeks 16 and 24 in Patients with a Baseline HADS-D Score of <8 or ≥8 and <11 or ≥112
|
|
|
|
---|
Week 16
|
Patients with a baseline HADS-D score of ≥8, n
| 63
| 130
| 70
|
HADS-D score of <8, n (%)
| 17 (27.0)
| 77 (59.2)
| 38 (54.3)
|
P value vs placebo
| -
| <0.001
| 0.003
|
Patients with a baseline HADS-D score of <8, n
| 173
| 347
| 164
|
HADS-D score of ≥8, n (%)
| 17 (9.8)
| 24 (6.9)
| 19 (11.6)
|
P value vs placebo
| -
| 0.156
| 0.537
|
Patients with a baseline HADS-D score of ≥11, n
| 35
| 59
| 32
|
HADS-D score of <11, n (%)
| 11 (31.4)
| 45 (76.3)
| 21 (65.6)
|
P value vs placebo
| -
| <0.001
| <0.001
|
Patients with a baseline HADS-D score of <11, n
| 201
| 418
| 202
|
HADS-D score of ≥11, n (%)
| 10 (5.0)
| 14 (3.3)
| 9 (4.5)
|
P value vs placebo
| -
| 0.238
| 0.706
|
Week 24
|
Patients with a baseline HADS-D score of ≥8, n
| -
| 127
| 69
|
HADS-D score of <8, n (%)
| -
| 76 (59.8)
| 32 (46.4)
|
P value vs adalimumab
| -
| -
| 0.079
|
Patients with a baseline HADS-D score of <8, n
| -
| 343
| 161
|
HADS-D score of ≥8, n (%)
| -
| 26 (7.6)
| 13 (8.1)
|
P value vs adalimumab
| -
| -
| 0.834
|
Patients with a baseline HADS-D score of ≥11, n
| -
| 56
| 31
|
HADS-D score of <11, n (%)
| -
| 39 (69.6)
| 19 (61.3)
|
P value vs adalimumab
| -
| -
| 0.730
|
Patients with a baseline HADS-D score of <11, n
| -
| 414
| 199
|
HADS-D score of ≥11, n (%)
| -
| 12 (2.9)
| 7 (3.5)
|
P value vs adalimumab
| -
| -
| 0.690
|
Abbreviations: HADS-D, Hospital Anxiety and Depression Scale-Depression. aPatients who were randomized and had the HADS scores at baseline.
|
- During the 16-week placebo-controlled period, 1 (0.2%) patient in the TREMFYA group reported an adverse event (AE) of generalized anxiety disorder and 2 (0.8%) patients in the adalimumab group and none in the placebo group reported an AE of anxiety.
- No events of depression, suicidal ideation, or suicidal behavior were reported in the TREMFYA group. One (0.4%) event of suicide attempt was reported in the adalimumab group.
- One (0.2%) event of suicidal ideation was reported in the TREMFYA group during the 28-week active comparator-controlled period.
- Both AEs in the TREMFYA group were non-serious, moderate in severity, and did not result in treatment discontinuation.
VOYAGE 2: HADS-D Results through Week 204
Reich et al (2020)3 presented results from the VOYAGE 2 study on the maintenance of responses, including impact of moderate to severe plaque PsO on HRQoL, with continuous treatment with TREMFYA through week 204.
- At baseline, 27.7% of all patients had depression (HADS-D score of ≥8), and among patients treated with TREMFYA, 16.6% and 21.0% had depression at weeks 100 and 204, respectively.
- Among patients who crossed over from adalimumab to TREMFYA (adalimumab→TREMFYA), 15.6% had depression at week 204.
VOYAGE 2: HADS-D Results through Week 252
Reich et al (2021)4 reported results from the VOYAGE 2 study on improvements in HRQoL, anxiety and depression, and work productivity through week 252 of treatment with TREMFYA.
Proportion of Patients Achieving an HADS-D Score of <8 at Weeks 100 and 2524 |
|
|
|
---|
Week 100d
|
n
| 178
| 58
| 236
|
Proportion of patients with an HADS-D score of <8, %
| 58.4
| 51.7
| 56.8
|
Week 252d
|
n
| 149
| 46
| 195
|
Proportion of patients with an HADS-D score of <8, %
| 59.1
| 52.2
| 57.4
|
Abbreviation: HADS-D, Hospital Anxiety and Depression Scale-Depression. aIncludes patients randomized to TREMFYA at baseline and those randomized to placebo at baseline who were crossed over to TREMFYA at week 16. bIncludes patients randomized to adalimumab at baseline who were crossed over to TREMFYA at or after week 28. cIncludes patients randomized to TREMFYA at baseline, those randomized to placebo at baseline who were crossed over to TREMFYA at week 16, and those randomized to adalimumab at baseline who were crossed over to TREMFYA at or after week 28. dThe denominator for percentages was based on the number of patients (n), with both baseline and follow-up measurements within a treatment group and baseline status after treatment failure rules were applied.
|
LITERATURE SEARCH
A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, and DERWENT® (and/or other resources, including internal/external databases) was conducted on 02 April 2024.
1 | Reich K, Armstrong AW, Foley P, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phase 3, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol. 2017;76(3):418-431. |
2 | Gordon KB, Armstrong AW, Han C, et al. Anxiety and depression in patients with moderate-to-severe psoriasis and comparison of change from baseline after treatment with guselkumab vs. adalimumab: results from the phase 3 VOYAGE 2 study. J Eur Acad Dermatol Venereol. 2018;32(11):1940-1949. |
3 | Reich K, Armstrong AW, Foley P, et al. Maintenance of response through up to 4 years of continuous guselkumab treatment of psoriasis in the VOYAGE 2 phase 3 study. Am J Clin Dermatol. 2020;21(6):881-890. |
4 | Reich K, Gordon KB, Foley P, et al. Sustained improvement in general health-related quality of life and work productivity in patients with moderate to severe psoriasis treated with guselkumab: 5-year data from clinical trial VOYAGE 2. Poster presented at: American Academy of Dermatology (AAD); April 23-25, 2021; Virtual Meeting. |