IL-17A Inhibition With Treatment Improves Symptoms of Psoriatic Arthritis

Recent data demonstrates the effectiveness of secukinumab in reducing synovitis in patients with psoriatic arthritis.

As part of the randomized, placebo-controlled phase 3 ULTAMATE study, researchers investigated the dynamics of response of synovitis to IL-17A inhibition with secukinumab in patients with active psoriatic arthritis using power doppler ultrasound.

Eligible trial participants had psoriatic arthritis with active ultrasound synovitis, clinical synovitis, and enthesitis, were experiencing inadequate response to conventional disease-modifying antirheumatic drugs (DMARDs) and were naïve to biologic DMARDs.

Patients were randomly assigned to either weekly subcutaneous secukinumab at 150 mg or 300 mg based on disease severity or placebo with 4-weekly dosing thereafter.

A total of 166 patients met inclusion criteria, of which 97% completed the full 12 weeks of treatment (secukinumab, 99%; placebo, 95%).

The adjusted mean change in the ultrasound Global EULAR and OMERACT Synovitis Score (GLOESS) from baseline to week 12 was higher with secukinumab than placebo [-9 (0.9) vs -6 (0.9), difference (95% CI): -3 (-6, -1); one-sided P = .004].

Researchers observed significant differences in GLOESS between secukinumab and placebo as early as the first week after beginning treatment. ACR 20 and 50 responses, the secondary endpoints, were also met.

“This unique ultrasound study shows that apart from improving the signs and symptoms of PsA, IL-17A inhibition with secukinumab leads to a rapid and significant reduction of synovitis in PsA patients,” concluded researchers.

Reference:
D'Agostino MA, Schett G, López-Rdz A, et al. Response to secukinumab on synovitis using Power Doppler ultrasound in psoriatic arthritis: 12-week results from a phase III study, ULTIMATE. Rheumatology (Oxford). 2022;61(5):1867-1876. doi:10.1093/rheumatology/keab628