Annals of the Rheumatic Diseases · 2018 · 301 citations · 29 references
MedicineImmunologyPharmacotherapyAutoimmunityImmunotherapyRheumatologyAnti-inflammatory PharmacologyCytokine BiologyInflammatory ArthritisInflammatory Disease PharmacotherapyInflammatory ProcessesPsoriatic ArthritisInterleukin 17 InhibitionInterleukin Inhibitor TherapyInterleukin-17 InhibitorsPsoriasis ImmunopathologyPsoriasis TherapyPsoriatic DiseaseRadiographic Progression
<h3>Objectives</h3> To evaluate the effect of subcutaneous (s.c.) secukinumab, an interleukin-17A inhibitor, on clinical signs and symptoms and radiographic progression in patients with psoriatic arthritis (PsA). <h3>Methods</h3> Adults (n=996) with active PsA were randomised 2:2:2:3 to s.c. secukinumab 300 mg or 150 mg with loading dose (LD), 150 mg without LD or placebo. All groups received secukinumab or placebo at baseline, weeks 1, 2 and 3 and then every 4 weeks from week 4. The primary endpoint was the proportion of patients achieving an American College of Rheumatology 20 (ACR20) response at week 16. <h3>Results</h3> Significantly more patients achieved an ACR20 response at week 16 with secukinumab 300 mg with LD (62.6%), 150 mg with LD (55.5%) or 150 mg without LD (59.5%) than placebo (27.4%) (p<0.0001 for all; non-responder imputation). Radiographic progression, as measured by van der Heijde-modified total Sharp score, was significantly inhibited at week 24 in all secukinumab arms versus placebo (p<i><</i>0.01 for 300 mg with LD and 150 mg without LD and p<0.05 for 150 mg with LD; linear extrapolation). Adverse event rates at week 24 were similar across treatment arms: 63.1% (300 mg with LD), 62.7% (150 mg with LD), 61.1% (150 mg without LD) and 62.0% (placebo). No deaths or new safety signals were reported. <h3>Conclusion</h3> S.c. secukinumab 300 mg and 150 mg with and without LD significantly improved clinical signs and symptoms and inhibited radiographic structural progression versus placebo at week 24 in patients with PsA. <h3>Trial registration number</h3> NCT02404350; Results.
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World Medical Association Declaration of Helsinki
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