Five-year Efficacy of Secukinumab in PsA

Patients with psoriatic arthritis (PsA) may observe improved long-term outcomes with secukinumab treatment, according to the results of a five-year study.

“Biologic therapies, such as anti–tumor necrosis factor (TNF) and anti–interleukin (IL)‐17A antibodies, are recommended for the treatment of PsA in patients who experience an inadequate response to first‐line treatment with nonsteroidal anti‐inflammatory drugs (NSAIDs) and/or disease‐modifying antirheumatic drugs (DMARDs),” the researchers explained.

Three-year findings from FUTURE 1 observed that secukinumab significantly inhibited joint structural damage through 24 weeks and that the benefits persisted through year three. In this report, researchers presented the five-year efficacy and safety results.

Inclusion criteria for FUTURE 1 included PsA patients with moderate to severe symptoms for at least six months, as well as at least three tender joints and three swollen joints at baseline. Anti-TNF inadequate responders (anti-TNF-IR) was defined as achieving no significant benefit from an anti-TNF therapy after three months or terminated treatment due to intolerability issues.

The main outcome measure was the long-term efficacy of secukinumab, measured as the proportion of patients achieving 20% or greater, 50% or greater, or 70% or greater improvement in the American College of Rheumatology criteria for improvement (ACR20, ACR50, and ACR70, respectively).

Of 236 patients in the secukinumab 150-mg group, 193 (81.8%) finished five years of treatment; of those patients, 36.4% (n = 86/236) escalated from 150 mg to 300 mg. Secukinumab was associated with sustained improvements in all efficacy endpoints over five years; at five years, 71.0% of patients achieved ACR20 responses, 51.8% achieved ACR50 responses, and 36.3% achieved ACR70 responses. Patients who required dose escalation presented improved efficacy comparably with patients who did not require dose escalation. The authors reported the following exposure-adjusted incidence rates per 100-person years for any dose of secukinumab: serious infection, 1.8; Crohn’s disease, 0.2; Candida infection, 0.9; and major cardiac adverse events. 0.5. No new safety signals were reported.

The study was published in ACR Open Rheumatology.

“Results from this long‐term extension study confirm the benefit of IL‐17 inhibition with secukinumab for sustained improvements in the signs and symptoms of major clinical domains of PsA,” the study authors concluded. “With no new safety concerns over a treatment period of up to 5 years, results from the 5‐year phase III FUTURE 1 study support the long‐term efficacy, safety, and tolerability of secukinumab in the treatment of patients with PsA.”