Secukinumab improves outcomes in active psoriatic arthritis patients: BMJ

Improvements in physical performance, health-related quality of life, and suppression of the development of structural damage were observed in individuals with active psoriatic arthritis (PsA) receiving secukinumab treatment, says an article published in BMJ Rheumatic and Musculoskeletal Diseases. 

In the phase 3 FUTURE study, patients with PsA saw consistent improvements in indications, symptoms, physical function, and health-related quality of life over a 5-year period after receiving secukinumab, a human monoclonal antibody that suppresses interleukin-17A (IL-17A). The proportion of secukinumab-treated patients with active PsA who attained and sustained LDA or REM, as well as the possible advantages and predictors of obtaining long-term sustained LDA/ REM, were examined by Coates and team in this retrospective analysis of data from the 2-year FUTURE 5 trial. 

According to LDA, patients in FUTURE 5 were divided into three groups: those who did not achieve LDA/REM, did so once, or did so three or more times between 24 weeks and 2 years. Secukinumab 300 mg, secukinumab 150 mg loading and non-loading, and placebo treatment groups each had 996 patients in total.21.4% of the patients stopped treatment before or after year 2. 

The key findings of this study were:

No matter the utilized outcome metric, i.e. MDA or DAPSA LDA+REM, at 2 years, 48% to 81% of patients treated with secukinumab 150 mg or 300 mg were able to attain sustained LDA. 

Only 19% to 36% of patients, however, were able to experience continuous REM for the full two years. 

Sustained LDA/REM resulted in quantitatively higher gains in physical function and quality of life than LDA/REM attained only once or not at all. 

Despite obtaining persistent LDA/REM, a significant number of secukinumab-treated patients showed no development of structural damage after 2 years. 

Patients who attained a sustained LDA were younger, had a lower body mass index (BMI) at baseline, and experienced less PsA discomfort and sensitive joints at week 16.

In conclusion, these findings support the efficacy of MDA and DAPSA LDA+REM as PsA therapy objectives since achieving them improved PsA patients' physical function and health-related quality of life in clinically significant ways. Patients who maintain these strict results typically have a lower BMI, are younger, and have milder illness states, which underlines the need for early intervention in terms of disease diagnosis and care.

Reference: 

Coates, L. C., Mease, P. J., Gladman, D. D., Navarra, S., Bao, W., & Gaillez, C. (2023). Secukinumab improves physical function and quality of life and inhibits structural damage in patients with PsA with sustained remission or low disease activity: results from the 2-year phase 3 FUTURE 5 study. In RMD Open (Vol. 9, Issue 2, p. e002939). BMJ. https://doi.org/10.1136/rmdopen-2022-002939