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04-03-2021 | Psoriatic arthritis | Adis Journal Club | Article

Drugs

Secukinumab: A Review in Psoriatic Arthritis

Authors: Hannah A. Blair

Abstract

Secukinumab (Cosentyx®) is a fully human monoclonal antibody that selectively targets interleukin (IL)-17A, a proinflammatory cytokine involved in the pathogenesis of psoriatic arthritis (PsA). Administered subcutaneously, the first-in-class anti-IL-17 agent is approved in numerous countries worldwide for the treatment of adults with active PsA. In the phase III FUTURE trials, secukinumab 150 or 300 mg improved the clinical signs and symptoms of PsA versus placebo in patients with active disease despite previous treatment with NSAIDs, biological disease-modifying anti-rheumatic drugs (bDMARDs) and/or tumour necrosis factor inhibitors (TNFi). The benefits of secukinumab were seen regardless of whether or not patients had received previous TNFi therapy, and were maintained during longer term (up to 5 years) treatment. In FUTURE 1 and 5, secukinumab inhibited structural joint damage and was associated with sustained low rates of radiographic progression through 1–3 years of treatment. Treatment with secukinumab improved physical function and health-related quality of life (HR-QOL) and was generally well tolerated, both in the short- and longer-term. In the head-to-head EXCEED trial, secukinumab did not quite attain statistical significance for superiority versus adalimumab in the joint domain. In conclusion, secukinumab is effective across all key PsA domains and is generally well tolerated, and thus represents a useful treatment alternative to TNFi and other bDMARDs in adult patients with active PsA.

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Secukinumab: clinical considerations in psoriatic arthritis

First-in-class fully human monoclonal antibody targeted against IL-17A

Improves clinical signs and symptoms, physical function and HR-QOL, with benefits sustained over the longer term (up to 5 years)

Associated with low rates of radiographic progression

Effective in both TNFi-naïve and -experienced patients and regardless of concomitant methotrexate use

Generally well tolerated

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