Secukinumab provides rapid and sustained reductions in dactylitis, enthesitis, and nail psoriasis in patients with psoriatic arthritis (PsA)

Introduction: Dactylitis, enthesitis and nail psoriasis are common manifestations of PsA. Here we report the effects of secukinumab (an anti-IL-17A monoclonal antibody) on dactylitis, enthesitis and nail-psoriasis through 52-weeks in patients with PsA in the FUTURE 2 study (NCT01752634).
Materials and Methods: FUTURE-2 data was assessed for the proportions of patients with resolution of dactylitis and enthesitis at weeks 24 and 52 (secondary endpoint), changes from baseline in dactylitic digit and enthesitis site counts at weeks 24 and 52 (post-hoc analysis) and changes from baseline in total fingernail modified NAil Psoriasis Severity Index (mNAPSI) score (exploratory endpoint).
Results: Of the 397 pts randomised, 35%, 64% and 70.3% had dactylitis, enthesitis and nail-psoriasis, respectively, at baseline. Kaplan Meier curves indicated that median time to resolution of dactylitis and enthesitis with secukinumab 300 and 150 mg was week 4. At week 24, a greater proportion of secukinumab-treated patients achieved complete resolution of dactylitis and enthesitis vs Placebo (secukinumab-300mg; 56.5% resolved dactylitis, 48.2% resolved enthesitis at week 24 vs 14.8%/21.5% of placebo patients (P<0.01)). A sustained decrease in mean changes from baseline to week 24 and 52 in dactylitis and enthesitis counts was observed. Mean change from baseline in mNAPSI score observed with secukinumab at week 24 was sustained or improved through week 52 (secukinumab 300mg change in baseline at week-24: -10.3, at week 52: -11.4 vs placebo at week 24: -4.85 (P<0.01)).
Conclusion: Secukinumab provided rapid improvements in dactylitis, enthesitis and nail psoriasis with improvements sustained through week 52.

Dr. Peter Nash