Secukinumab provides ‘rapid and sustained’ pain relief for PsA patients
medwireNews: A post-hoc analysis of the FUTURE 2 trial suggests that patients with psoriatic arthritis (PsA) who are treated with secukinumab experience improvements in pain scores after 3 weeks of treatment, and these responses are maintained for up to 2 years.
The interleukin-17A–targeted antibody “has previously demonstrated efficacy in treatment of the signs and symptoms of PsA, inhibition of radiographic progression in patients with PsA, and a favorable safety profile,” Iain McInnes (University of Glasgow, UK) and co-investigators write in Arthritis Research & Therapy.
“Pain is one of the most important domains affecting HRQoL [health-related quality of life] in patients with PsA, and [these patients] report role limitations caused by both emotional problems and bodily pain,” they explain.
The FUTURE 2 investigators randomly assigned participants to receive subcutaneous secukinumab at a dose of 300 mg, 150 mg, or 75 mg, or placebo, every week for 4 weeks, followed by 4-weekly dosing thereafter. Placebo-treated patients were re-randomized to receive secukinumab 300 mg or 150 mg from week 16 or 24, and treatment was continued for up to 2 years.
In their post-hoc analysis, McInnes and team found that average pain scores on a visual analog scale (VAS) decreased by 16.9 points from baseline to week 3 among 100 patients treated with secukinumab 300 mg, and by 12.6 points among 100 patients in the secukinumab 150 mg group.
These improvements were significantly greater than the 5.8-point decrease seen for the 98 patients in the placebo group, and the decreases in VAS pain scores were maintained over 2 years of secukinumab treatment.
Secukinumab-treated patients also reported significantly greater improvements in Short Form-36 bodily pain domain scores than those given placebo by the 4-week follow-up, and these benefits were also maintained until the 2-year follow-up.
Moreover, a numerically greater proportion of patients treated with secukinumab versus placebo reported no pain or discomfort in the EuroQoL 5-Dimension 3-Level questionnaire at week 4, and “the proportion of patients reporting no pain or discomfort continued to increase over time” with secukinumab treatment, report the investigators.
These findings indicate that “[s]ecukinumab provides rapid and sustained pain relief in psoriatic arthritis over 2 years,” irrespective of the measure used for pain assessment, they write.
In subgroup analyses, improvements in pain measures with secukinumab versus placebo treatment were significant in both patients with prior tumor necrosis factor (TNF) inhibitor exposure and those who were TNF-naïve. The researchers note, however, that the magnitude of improvement was “generally lower” among those with a previous inadequate response or intolerance to TNF inhibitor treatment.
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