Secukinumab Shows 2-Year Sustained Improvement for Patients Experiencing Concomitant Nail Psoriasis

The FUTURE 5 study revealed that secukinumab can improve nail disease as well as signs and symptoms of psoriatic arthritis (PsA), and a low rate of radiographic progression, for 2 years in patients who experience PsA with noncomitant nail psoriasis.

Patients were randomized to receive secukinumab (300 mg with 300-mg loading dose, 150 mg with 150-mg load, or 150 mg with no load) or placebo weekly and then every 4 weeks thereafter. After 104 weeks of treatment, post hoc analysis included modified Nail Psoriasis Severity (mNAPSI), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and radiographic progression per assessed by van der Heijde-modified total Sharp score (vdH-mTSS). Resolution of dactylitis and enthesitis was also evaluated.

In total, 663 patients out of the 996 in the trial had concomitant nail psoriasis at baseline. At week 16, mNAPSI score was significantly reduced and DLQI saw significant improvement for all experimental arms vs placebo. These improvements were sustained through week 104 of the trial. “The proportion of patients with no radiographic progression (change from baseline in vdH-mTSS≤0.5) at week 104 was 91.9% (300 mg) 78.9% (150 mg), and 82.4% (150 mg no load),” added the study authors.

This report evaluating the sustained increase in efficacy of secukinumab on nail psoriasis and other psoriatic disease manifestations in patients with PsA showed new promise for treating localized disease. Further evaluation and studies are needed to determine how much longer the positive improvements can be sustained after 2 years.

Reference
Nash P, Mease PJ, Kirkham B, et al. Secukinumab provides sustained improvement in nail psoriasis, signs and symptoms of psoriatic arthritis and low rate of radiographic progression in patients with concomitant nail involvement: 2-year results from the phase III FUTURE 5 study. Clin Exp Rheumatol. Published online September 3, 2021. Accessed September 15, 2021. https://pubmed.ncbi.nlm.nih.gov/34494957/