medwireNews: Patients with psoriatic arthritis (PsA) who are treated with the interkeukin-17 inhibitor secukinumab have an increased likelihood of achieving minimal disease activity (MDA), suggests an analysis of data from the FUTURE 2 trial.
In the phase III study, patients with active PsA were randomly assigned to receive treatment with secukinumab (300, 150, or 75 mg) or placebo once weekly for 4 weeks, and every 4 weeks thereafter. Placebo-treated patients were re-randomized to receive secukinumab at one of the approved doses (300 or 150 mg) at week 16 or 24.
At the 16-week follow-up, the 98 patients receiving secukinumab 300 mg and the 100 patients given secukinumab 150 mg were significantly more likely to achieve MDA – a composite outcome including patient-reported outcomes, peripheral arthritis, and skin measures – than the 96 placebo-treated patients, with rates of 28% and 23%, respectively, versus 10%.
And at week 24, the MDA response rates were 32% for patients treated with secukinumab 300 mg and 25% for those given the 150 mg dose.
These MDA responses were “maintained and continued to improve through Week 104,” report Laura Coates (University of Oxford, UK) and fellow investigators.
In subgroup analyses, MDA response rates were markedly higher with secukinumab 300 mg or 150 mg versus placebo among the 188 patients who were tumor necrosis factor (TNF) inhibitor-naïve (34 and 32, respectively, vs 13%) and among the 104 with a previous inadequate response to anti-TNF agents (15 and 8 vs 3%).
“The finding that greater MDA can be achieved in anti–TNF-naïve PsA patients with early disease is notable and supports the rationale for early and aggressive treatment,” write the researchers. However, they caution that these findings were limited by the small number of patients in the different subgroups.
The team also found that patients who achieved MDA in the FUTURE 2 trial experienced greater improvements in health-related quality of life, fatigue, and social functioning scores at week 16 than those who did not, and these benefits were maintained for up to 2 years.
“Thus, achieving MDA directly translates to benefits for patients in the most relevant aspects,” conclude Coates and colleagues in Arthritis Care & Research.
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