OBJECTIVE: Evaluate ustekinumab, an anti-interleukin (IL)-12 and IL-23 antibody, 
effects on radiographic progression in psoriatic arthritis (PsA).
METHODS: We conducted preplanned integrated analyses of combined radiographic 
data from PSUMMIT-1 and PSUMMIT-2 phase 3, randomised, controlled trials. 
Patients had active PsA despite prior conventional and/or biologic 
disease-modifying antirheumatic drugs (≥5/66 swollen, ≥5/68 tender joints, 
C-reactive protein ≥3.0 mg/L, documented plaque psoriasis). Patients (PSUMMIT-1, 
n=615; PSUMMIT-2, n=312) were randomised to ustekinumab 45 mg, 90 mg, or 
placebo, at weeks (wk) 0, 4 and every (q) 12 wks. At wk 16, patients with <5% 
improvement in tender/swollen joint counts entered blinded early escape. All 
other placebo patients received ustekinumab 45 mg at wk 24 and wk 28, then q 12 
wks. Radiographs of hands/feet at wks 0/24/52 were assessed using PsA-modified 
van der Heijde-Sharp (vdH-S) scores; combined PSUMMIT-1 and PSUMMIT-2 changes in 
total vdH-S scores from wk 0 to wk 24 comprised the prespecified primary 
radiographic analysis. Treatment effects were assessed using analysis of 
variance on van der Waerden normal scores (factors=treatment, baseline 
methotrexate usage, and study).
RESULTS: Integrated data analysis results indicated that ustekinumab-treated 
patients (regardless of dose) demonstrated significantly less radiographic 
progression at wk 24 than did placebo recipients (wk 0-24 total vdH-S score mean 
changes: 0.4-combined/individual ustekinumab dose groups, 1.0-placebo; all 
p<0.02). From wk 24 to wk 52, inhibition of radiographic progression was 
maintained for ustekinumab-treated patients, and progression was substantially 
reduced among initial placebo recipients who started ustekinumab at wk 16 or wk 
24 (wk 24 - wk 52, total vdH-S score mean change: 0.08).
CONCLUSIONS: Ustekinumab 45 and 90 mg treatments significantly inhibited 
radiographic progression of joint damage in patients with active PsA.