Secukinumab, adalimumab show similar efficacy resolving enthesitis in psoriatic arthritis
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Key takeaways:
- In patients with psoriatic arthritis, secukinumab and adalimumab demonstrated similar results regarding enthesitis resolution.
- Consistency was maintained across timepoints and measurement methods.
Secukinumab and adalimumab demonstrate similar efficacy regarding the resolution of enthesitis over 52 weeks in patients with psoriatic arthritis, according to data published in Rheumatology.
“The [European Alliance of Associations for Rheumatology (EULAR)] guidelines recommend biologic disease-modifying antirheumatic drugs (bDMARDs) for patients with enthesitis and an inadequate response to or intolerance of nonsteroidal anti-inflammatory drugs (NSAIDs),” Gurjit S. Kaeley, MD, of the University of Florida College of Medicine, and colleagues wrote. “However, no guidance on specific bDMARDs is offered.”
To investigate the effectiveness of adalimumab (Humira, AbbVie) and secukinumab (Cosentyx, Novartis) for the resolution of enthesitis, Kaeley and colleagues conducted a post hoc analysis of the EXCEED study, a multicenter, randomized, double-blind, active-controlled, parallel-group phase 3 trial that compared the two drugs in patients with PsA. The trial included patients with a PsA diagnosis who demonstrated “active plaque psoriasis or nail changes consistent with psoriasis,” the researchers wrote. In addition, eligible patients were required to be naïve to DMARDs.
Patients were randomized 1:1 to receive either secukinumab 300 mg or adalimumab 40 mg, and were grouped according to the presence or lack of enthesitis at baseline. After 52 weeks, patients with enthesitis at baseline were evaluated for several factors, including the median time to resolution, the average score of the Leeds Enthesitis Index (LEI) and the Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC). In addition, the average change from baseline at 24 and 52 weeks, as well as any relapse following initial resolution, were evaluated. The researchers also gathered information on quality-of-life changes through patient-reported outcome surveys.
In all, 498 patients with enthesitis, as measured by LEI, and 632 patients with enthesitis, as measured by SPARCC scores, were included in the analysis. According to the researchers, similar proportions of patients receiving each drug achieved resolution at the 24- and 52-week timepoints. At 24 weeks, among patients receiving secukinumab, 49.6% achieved resolution as measured by LEI, while 45.8% achieved resolution as measured by SPARCC. Meanwhile, in patients receiving adalimumab, 43.6% — as measured by LEI — and 43.5% — according to SPARCC — achieved resolution.
Proportions remained similar at 52 weeks. In the secukinumab group, 60.7% of patients as measured by LEI, and 53.2% of patients as measured by SPARCC, achieved resolution. In patients treated with adalimumab, 55.3% achieved resolution as measured by LEI, while 51.4% achieved resolution as measured by SPARCC.
“Although the overall primary outcome of superiority of ACR20 response for secukinumab vs. adalimumab was not met in EXCEED, this post hoc analysis indicates that secukinumab and adalimumab resulted in similar improvements in enthesitis,” Kaeley and colleagues wrote. “Both drugs showed similar time to response with respect to resolution of enthesitis, both overall and by severity at baseline.”
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