Secukinumab provides sustained improvement in psoriatic arthritis in both anti‒TNF-naïve and anti-TNF exposed patients
Introduction: Secukinumab (an anti–IL-17A monoclonal antibody) has demonstrated efficacy in psoriatic arthritis (PsA) in the phase 3 study; FUTURE-2 (NCT01752634). Here, we present the 52-week results for secukinumab by prior anti-TNF treatment.
Materials and Methods: Patients were randomised to receive subcutaneous secukinumab 300, 150, or 75 mg, or PBO at baseline, weeks 1, 2, 3, and 4, and then every 4 weeks from week 8. Randomisation was stratified by anti-TNF history: anti–TNF-naive, or inadequate response/intolerance to not more than 3 anti-TNF agents (anti–TNF-IR). The primary endpoint was ACR20 response at Wk 24. Secondary endpoints were PASI-75/90, DAS28-CRP, SF-36 PCS, HAQ-DI, ACR50, dactylitis, and enthesitis. ACR70 was an exploratory endpoint.
Results: Of the 397 pts enrolled, 65% were anti‒TNF-naïve and 35% were anti–TNF-IR. At week 24 ACR 20 responses were significantly higher with secukinumab versus PBO in both anti‒TNF-naïve and anti‒TNF-IR patients. Responses were sustained through to week 52. 58.2/68.7% of anti‒TNF-naïve patients receiving 300mg of secukinumab achieved an ACR20 at week 24/52 versus a placebo response of 15.9% at week 24. 45.5/54.5% of anti‒TNF-IR patients receiving 300mg of secukinumab achieved an ACR20 at week 24/52 versus a placebo response of 14.3% at week 24. Sustained Improvements were also observed for other secondary endpoints in both anti‒TNF-naïve and anti‒TNF-IR patients with improvements generally higher amongst anti‒TNF-naïve patients.
Conclusion: Secukinumab provided significant and sustained improvements in the signs and symptoms of PsA in both anti‒TNF-naïve and anti‒TNF-IR patients with the greatest responses observed in anti‒TNF-naïve patients.
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Dr. Stephen Hall
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