Secukinumab Improves Disease Severity, Functional Outcomes for Psoriatic Arthritis
Most patients with psoriatic arthritis (PsA) who were treated with secukinumab sustained low disease activity (LDA) or remission, which was associated with improved physical function, quality of life, and inhibition of structural damage progression, according to the results of a randomized, double-blind phase 3 study.1
In its latest treatment recommendations, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) called for the lowest disease activity level possible to be the treatment goal of all patients with PsA.2 Considering GRAPPA’s recommendations, the researchers in the current study aimed to determine the effectiveness of secukinumab on sustaining low levels of disease activity, as well as potential benefits and predictors of response.
Included in the study were 996 adult patients who had active PsA for 6 months, as classified by the Classification Criteria for Psoriatic Arthritis, at both screening and baseline. All participants randomly received secukinumab 300 mg with loading dose (n = 222), secukinumab 150 mg with loading dose (n = 220), secukinumab 150 mg without loading dose (n = 222), or placebo (n = 332).
Patients were grouped based on levels of disease activity by the end of the 104-week study period: those who did not achieve LDA or remission, those who achieved LDA or remission only once, and those who sustained LDA or remission 3 times or more from week 24 to week 104.
By the end of the study period, 48% to 81% of patients treated with secukinumab sustained LDA, whereas 19% to 36% sustained remission. Greater improvements in both physical function and quality of life were observed in patients who sustained these levels of disease severity when compared with those who had not achieved LDA or remission or only achieved these levels once. However, patients reached the established minimal clinically importance difference for all composite indices. At 2 years of treatment, most patients treated with secukinumab did not show any radiographic progression regardless of achieving sustained LDA or remission.
Individuals with younger age, lower BMI at baseline, reduced tender joint count, and PsA pain at week 16 were all factors associated with sustained LDA in patients treated with secukinumab.
“In conclusion, these analyses provide further insights into the long-term achievement of LDA or remission in patients treated with secukinumab which is associated with better long-term function and patient reported outcome benefits,” the researchers concluded. “The study also highlights the protective effect of secukinumab on inhibition of structural progression irrespective of the level of disease activity."
References:
- Coates LC, Mease PJ, Gladman DD, Navarra S, Bao W, Gaillez C. Secukinumab improves physical function and quality of life and inhibits structural damage in patients with PsA with sustained remission or low disease activity: results from the 2-year phase 2 FUTURE 5 study. RMD Open. Published online April 24, 2023. Accessed May 11, 2023. doi:10.1134/rmdopen-2022-002939
- Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022;18:465-479. doi:10.1038/s41584-022-00798-0