Both secukinumab 300 mg and secukinumab 150 mg significantly improved signs and symptoms of axial disease in patients with psoriatic arthritis (PsA) who had inadequate response to non- steroidal anti-inflammatory drugs.<\/p>\n
Findings from a randomized controlled trial (RCT) are making the case for using secukinumab to treat axial disease in certain patients with psoriatic arthritis (PsA). Specifically, the trial found 2 doses of the interleukin (IL)-17A inhibitor yielded significant improvements in disease signs and symptoms.<\/p>\n
The MAXIMISE (Managing AXIal Manifestations in psoriatic arthritis with SEcukinumab) trial was the first RCT to test a biological disease modifying anti-rheumatic drugs ability to improve outcomes in axial manifestations of PsA. All patients previously had inadequate responses to at least 2 non-steroidal anti-inflammatory drugs over a 4-week period.<\/p>\n
The axial involvement represents an unmet clinical need in determining the treatment strategy across all PsA manifestations and ultimately supports informed treatment decision-making, wrote the researchers. Additionally, patients with PsA tend to under-report axial symptoms and consequently the burden of disease might be underestimated for axial disease in such patients. As a consequence, the efficacy of a biological treatment in managing axial symptoms in PsA has been investigated only in two observational studies to date, and never in a randomized controlled setting.<\/p>\n
A total of 425 patients completed the 52-week MAXIMISE study and received placebo or either secukinumab 300 mg or secukinumab 150 mg, both of which significantly improved responses compared with placebo after 12 weeks of treatment (63% and 66%, respectively, vs 31%).<\/p>\n
Compared with placebo, the odds ratio of having an improved response as determined by the Assessment of SpondyloArthritis International Society (ASAS20)defined as an improvement of 20% and 1 unit on a scale of 10 in at least 3 of the 4 main ASAS domainswas 3.8 for patients receiving secukinumab 300 and 4.4 for patients receiving secukinumab 150 mg.<\/p>\n
Responses rates for patients receiving secukinumab 300, secukinumab 150 mg, or switching from placebo to either secukinumab dose were 81%, 80%, and 75%, respectively. The responses were durable, researchers found, with patients sustaining responses through the end of the study.<\/p>\n
In addition, MRI assessments demonstrated that secukinumab 300 mg and 150 mg significantly improved Berlin MRI scores versus placebo, providing objective evidence of reduced inflammation in both the spine and the [sacroiliac joints] for patients treated with secukinumab, authors wrote.<\/p>\n
Researchers observed comparable types and incidences of adverse events between the monoclonal antibody and placebo. No notable differences were seen between the 2 secukinumab doses.<\/p>\n
Reference: Baraliakos X, Gossec L, Pournara E, et al. Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial. Ann Rheum Dis. Published online December 17, 2020. doi:10.1136\/annrheumdis-2020-218808<\/p>\n
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