medwireNews: Women with psoriatic arthritis (PsA) may gain greater improvement in disease outcomes with secukinumab than with adalimumab, a post-hoc analysis of the EXCEED trial shows.
The Phase 3b EXCEED study compared secukinumab and adalimumab as first-line therapy in biologic-naïve patients with PsA, and found no difference in the primary outcome of the ACR20 response rate at 52 weeks. However, after adjusting for minor imbalances in sex and smoking status between the randomized groups there was a significant difference favoring secukinumab.
Grace Wright (New York, USA) and colleagues therefore explored the difference in treatment outcomes according to sex and found that the 218 women taking secukinumab 300 mg had significantly higher ACR20, ACR50, PASI90, and HAQ-DI response rates at week 52 than the 198 taking adalimumab 40 mg.
The rates, as presented at the ACR Convergence 2020 virtual meeting, were 61.0% versus 51.5% for ACR20, 43.0% versus 32.6% for ACR50, 64.0% versus 37.6% for PASI90, and 53.7% versus 43.9% for HAQ-DI (≥0.35 points).
Wright told delegates that when they looked at each of the individual American College of Rheumatology components individually there was “no single component that drove this response.”
Significant improvement in outcomes in favor of secukinumab was also seen for the DAPSA and PASDAS low disease activity and remission composite indices.
Among the men, by comparison, treatment efficacy was generally higher overall, but there was only a significant difference in treatment effect for skin response, with significantly more men taking secukinumab achieving a PSAI90 response, at 66.9% compared with 48.2% of men taking adalimumab. Wright noted that women tended to have a higher burden of disease at baseline than men.
She concluded: “These interesting findings warrant further investigation for reproducibility or uniqueness.”
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