Secukinumab Effects Greatest in PsA Patients Naïve to TNFi Treatment

Patients who took secukinumab, regardless of prior tumor necrosis factor inhibitor (TNFi) use, experienced more improvement in psoriatic arthritis disease activity after 16 weeks than patients who took placebo, according to study results published online ahead of print in Rheumatology and Therapy.

“These results further support the value of secukinumab in improving the heterogeneous psoriatic arthritis disease spectrum, including health-related quality of life measures, in both TNFi-naïve and TNFi-inadequate responder patients,” researchers wrote.

The study was a post-hoc analysis of 2049 patients with active psoriatic arthritis from four phase 3 randomized controlled trials. Researchers were interested in evaluating the effect of prior TNFi use on secukinumab efficacy over 16 weeks.

At week 16, treatment with secukinumab improved disease activity across psoriatic arthritis core domains, as defined by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and endorsed by Outcome Measures in Rheumatology (OMERACT), compared with placebo. For most outcomes, however, patients who were TNFi-naïve who took secukinumab experienced improvements to a greater extent than patients who were TNFi-inadequate responders, according to the study.

Among TNFi-naive patients treated with secukinumab 300 mg, 41.5% had resolution in 66 swollen joint counts and 24.4% had resolution in 68 tender joint counts. Among those treated with secukinumab 300 mg who were TNFi-inadequate responders, 18.6% had resolution in 66 swollen joint counts and 9% had resolution in 68 tender joint counts.

Some 37.2% of TNFi-naive patients and 24.2% of TNFi-inadequate responder patients achieved complete resolution of psoriasis, researchers added.

“On the basis of numerically greater responses in TNFi-naive compared with TNFi-inadequate responder patients, secukinumab may be a preferred agent for the initial treatment of psoriatic arthritis,” researchers advised.

Reference:
Orbai AM, Husni ME, Gladman DD, et al. Secukinumab Efficacy on Psoriatic Arthritis GRAPPA-OMERACT Core Domains in Patients with or Without Prior Tumor Necrosis Factor Inhibitor Use: Pooled Analysis of Four Phase 3 Studies [published online ahead of print, 2021 Jul 3]. Rheumatol Ther. 2021;10.1007/s40744-021-00337-5. doi:10.1007/s40744-021-00337-5