How Does Real-World Evidence Differ From Randomized Controlled Trials?

Join Jennifer Mylod, NP, from Arizona Arthritis and Rheumatology Associates in Phoenix, as she breaks down the differences between randomized controlled trials (RCTs) and real-world evidence (RWE) in assessing psoriatic arthritis treatments. While RCTs provide highly controlled data on efficacy and safety, RWE offers valuable insights into how treatments perform in everyday clinical practice.

RCTs, like the Phase 3 COSMOS trial, are designed to eliminate bias by randomly assigning patients to treatment or placebo groups. In COSMOS, Guselkumab (Tremfya) showed significant improvements in joint and skin symptoms for PsA patients who had failed TNF inhibitors, establishing its efficacy in a controlled setting.

RWE, however, reflects real-world treatment patterns and patient outcomes. Unlike RCTs, it includes diverse populations with varied medical histories and prior treatments. A 12-month claims analysis from the IBM MarketScan database found that 72% of PsA patients on Guselkumab maintained treatment persistence, compared to 44% for subcutaneous TNF inhibitors. Additionally, data from the CorEvitas Registry showed that nearly 80% of patients continued Guselkumab for at least six months, with significant symptom improvements.

By considering both RCTs and RWE, clinicians gain a more comprehensive understanding of treatment effectiveness, helping them tailor therapy decisions to each patient’s unique needs.

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