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Patients with PsA may respond to older anti-TNF therapies, Cosentyx
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Patients with psoriatic arthritis who are intolerant to or fail to adequately respond to traditional disease-modifying anti-rheumatic drugs may respond to older anti-tumor necrosis factor-alpha treatment or to Cosentyx, according to a recently published meta-analysis.
Researchers studied the data from 12 random, controlled trials that compared the efficacy of biologic therapies to placebo in patients with psoriatic arthritis (PsA) who did not respond to traditional disease-modifying anti-rheumatic drugs (DMARDs). Included studies lasted at least 12 weeks, measured the response rate to treatment with the American College of Rheumatology (ACR) 20% improvement (ACR20) and included 1,989 treated patients and 1,175 patients who received placebo.
The researchers considered “older” anti-tumor necrosis factor-alpha therapies, Humira (adalimumab, AbbVie), Enbrel (etanercept, Amgen), Simponi (golimumab, Janssen) and Remicade (infliximab, Janssen), to be similar and considered the agents as a single category. Seven trials of older TNF inhibitors, two trials of Stelara (ustekinumab, Janssen), one trial of Otezla (apremilast, Celgene), one trial of Cimzia (certolimumab pegol, UCB) and a trial of Cosentyx (secukinumab, Novartis) were included. Baseline characteristics of all patients were similar, including average age, disease activity and 1:1 male-to-female ratio. All studies allowed the concomitant use of traditional DMARDs and reported the ACR20 response rate at 12 to 24 weeks.
The five groups were indirectly compared to placebo. A higher likelihood of achieving ACR20 was seen in patients who received older anti-TNF agents compared to 20 or 30 mg of apremilast, 45 or 90 mg of ustekinumab or 90 certolizumab pegol. The likelihood of achieving an ACR20 response was similar between the group of TNF inhibitors and secukinumab, and an ACR20 response was more likely in patients who received secukinumab compared to apremilast, certolizumab pegol and ustekinumab, but the difference did not always remain significant. No differences were seen between apremilast, certolizumab pegol and ustekinumab.
– by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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