6-month secukinumab use improves outcomes in psoriatic arthritis

Real-world patients with psoriatic arthritis (PsA) who received and remained on secukinumab treatment for 6 months has attained minimal disease activity (MDA) and shown improvements in clinical manifestations, patient-reported outcomes, and work productivity at follow-up, reveals a study. The results are consistent with findings from clinical trials.

“Additionally, our results suggest that secukinumab may be effective as biologic therapy for those patients both with and without prior biologic use,” the researchers said. “The results presented here provide evidence of the effectiveness of secukinumab for improving disease activity and QOL in patients with active PsA seen in routine clinical practice, regardless of prior biologic experience.”

Lead researcher Dr Philip J Mease from the Swedish Medical Center in Washington, US, and his team analysed patients with PsA in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry who initiated secukinumab treatment between 1 April 2017 and 2 December 2019 and maintained secukinumab at their 6-month follow-up.

Mease and colleagues evaluated the following at 6 months in all patients and in those who received secukinumab as a first-line biologic: achievement of MDA among patients not in MDA at initiation; resolution (ie, no evidence) of tender and swollen joint counts, enthesitis, and dactylitis among patients with ≥1 of these at initiation; and change in disease activity and patient-reported outcomes (PROs).

One hundred patients met the eligibility criteria, of which 83 had had biologic treatment and 17 initiated secukinumab as a first-line biologic. [J Rheumatol 2022;49:700-706]

At initiation, 75 out of 90 patients (83.3 percent) with available data were not in MDA, while 26 out of 71 patients (36.6 percent) with follow-up data achieved MDA at 6 months. The following patients also achieved resolution at 6 months: 28/68 (41.2 percent) with ≥1 tender joint, 24/54 (44.4 percent) with ≥1 swollen joint, 17/28 (60.7 percent) with enthesitis, and 9/12 (75.0 percent) with dactylitis at initiation.

Furthermore, improvements were seen in clinical manifestations, PRO measures, and work productivity and activity among PsA patients who initiated and maintained secukinumab for 6 months.

“MDA is a multidomain composite measure that assesses a range of symptoms, and patients who achieve MDA have been reported to experience overall better clinical benefit,” the researchers said. [J Rheumatol 2016;43:350-355; Arthritis Res Ther 2017;19:72]

“More than one-third of patients achieved MDA, and the overall cohort of secukinumab initiators included in this analysis achieved improvements in clinical manifestations, PRO measures, and work productivity with 6 months of continuous treatment,” they added.

The proportion of patients who remained on secukinumab treatment for 6 months and achieved MDA was comparable to those seen in clinical trials. Additionally, functional status, quality of life, and work productivity measures improved despite the huge number of biologic-experienced patients in this study compared with clinical trial populations. [Ann Rheum Dis 2018;77:890-897; Arthritis Rheumatol 2020;72:10; Arthritis Care Res 2018;70:1529-1535; Arthritis Res Ther 2018;20:47; Ann Rheum Dis 2017;76:203-207]

“Future studies with larger sample sizes and longer study durations should be conducted to evaluate the long-term effect of secukinumab on maintenance of MDA,” the researchers said.

“These findings provide additional evidence of the effectiveness of secukinumab for achievement of MDA in patients with PsA, regardless of prior biologic use,” they added.