Long-Lasting Inhibition of Radiographic Progression Shown with Secukinumab for Psoriatic Arthritis

Secukinumab (Cosentyx, Novartis) inhibited radiographic progression in approximately 90% of patients with psoriatic arthritis (PsA) over 2 years, according to new data from a phase 3 study.
Secukinumab, a fully-human biologic that directly inhibits interleukin-17A, is used for the treatment of PsA, psoriasis, and ankylosing spondylitis.
In PsA, patients can develop irreversible radiographic structural damage if symptoms are left untreated. Radiographic damage is defined by joint inflammation, erosion, and joint space narrowing, particularly in the hands and feet. More than half of patients with PsA report radiographic progression, according to Novartis.
The FUTURE 5 trial evaluated the efficacy of secukinumab on the signs and symptoms of PsA, in as well as inhibition of radiographic progression in 996 adults with active PsA. Patients were randomized to receive subcutaneous secukinumab 300 mg (with a loading dose [LD] of 300 mg), 150 mg (LD 150 mg), 150 mg with no LD, or a placebo at baseline at weeks 1, 2, 3, 4, and every 4 weeks thereafter. Starting from week 52, the dose could escalate from 150 to 300 mg based on the physicians’ judgement.
Overall, the study showed that 89.5% (300 mg), 82.3% (150 mg), and 81.1% (150 mg no LD) of patients with PsA treated with secukinumab found no radiographic progression at 2 years. Additionally, clinical responses, such as American College of Rheumatology criteria (ACR20/50) and Psoriasis Area and Severity Index (PASI 90/100), were also maintained through 2 years. According to the data, 77% of secukinumab 300 mg patients achieved ACR20, 51.9% achieved ACR50, 70.1% achieved PASI 90, and 49.5% achieved PASI 100. Patients treated at the lowest dose also achieved results: 79.4% ACR20, 52.6% ACR50, 59.2% PASI 90, and 44.2% PASI 100.
“Half of patients with psoriatic arthritis experience bone erosion within approximately 2 years,” Philip J. Mease, director of Rheumatology Research at Swedish Medical Center/Providence St. Joseph Health and Clinical Professor, University of Washington School of Medicine, said in a statement. “The availability of a treatment that is proven to inhibit progression of psoriatic arthritis through 2 years gives physicians and patients more choice in the management of this debilitating condition.”
Secukinumab has demonstrated long-lasting efficacy and sustained safety in three 5-year phase 3 extension studies across multiple manifestations of psoriatic disease. These results further reinforce its use as a rapid, long-lasting comprehensive treatment for patients with PsA.
Cosentyx provides long-lasting inhibition of radiographic progression in psoriatic arthritis, new Novartis data show [news release]. Novartis. https://www.novartis.com/news/media-releases/cosentyx-provides-long-lasting-inhibition-radiographic-progression-psoriatic-arthritis-new-novartis-data-show. Accessed June 18, 2019.

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