Secukinumab minimizes disease activity at 6 months in psoriatic arthritis
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Real-world patients with psoriatic arthritis who receive secukinumab for 6 months maintain consistent proportions of minimal disease activity and demonstrate improved patient-reported outcomes, according to data.
“Secukinumab, a fully humanized monoclonal antibody that selectively inhibits interleukin (IL)-17A is approved for the treatment of PsA and improves all PsA manifestations in the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) OMERACT core domain set,” Philip J. Mease, MD, of the University of Washington, in Seattle, and colleagues wrote in the Journal of Rheumatology. “However, few studies in the United States have evaluated the effectiveness of secukinumab in patients with PsA in real-world settings.”
To assess clinical and patient-reported outcomes following 6 months of secukinumab (Cosentyx, Novartis) therapy for PsA, Mease and colleagues analyzed patients in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry who received a confirmed diagnosis of PsA. Among the 3,393 patients in the registry, 324 began secukinumab treatment between April 1, 2017, and Dec. 2, 2019. Patients who received either 150 mg or 300 mg every 4 weeks, and completed a follow-up visit at 6 months, were included in the analysis, for a total of 100 participants.
Patient data were collected during therapy initiation and again at the 6-month visit via a questionnaire. The primary endpoint was the achievement of minimal disease activity among patients who had not achieved it prior to therapy initiation. The researchers considered the endpoint reached if a patient met five or more of seven criteria.
These criteria included a tender joint count of less than or equal to one, a swollen joint count of less than or equal to one, a psoriasis-affected surface area of less than or equal to 3%, patient pain based on a visual analog scale of 15 or less, a patient global assessment VAS of less than or equal to 20, a Health Assessment Questionnaire-Disability Index of less than or equal to 0.5 and tender entheseal points of less than or equal to one.
Secondary endpoints included swollen and tender joint resolution, enthesitis or dactylitis in patients who did not have them at treatment initiation.
Among the 100 included patients, 83 had received biologics, while 17 initiated secukinumab as a first-line biologic. Upon initiation, 75 out of 90 patients with available data had not achieved minimal disease activity. At the 6-month follow up, 26 out of 71 patients with follow-up data achieved minimal disease activity. Additionally, 28 out of 68 patients with one or more tender joint, 24 out of 54 patients with one or more swollen joints, 17 out of 28 patients with enthesitis and nine out of 12 patients with dactylitis experienced symptom resolutions, according to the researchers.
"More than one-third of real-world patients with PsA who were not in [minimal disease activity (MDA)] at secukinumab initiation and remained on treatment for 6 months achieved MDA and experienced improvements in clinical manifestations, PRO measures, and work productivity at 6-month follow-up, which is consistent with findings from clinical trials,” Mease and colleagues wrote. “Additionally, our results suggest that secukinumab may be effective as a biologic therapy for those patients both with and without prior biologic use.”
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