Secukinumab effective option in psoriatic arthritis and axial manifestations, Finds study
Researchers have recently noted that secukinumab 300 mg and 150 mg provided significant improvement in signs and symptoms of axial disease compared with placebo in patients with PsA, as published in the Annals of Rheumatic Diseases.
Secukinumab, a fully human monoclonal antibody that directly inhibits IL-17A, has provided significant and sustained improvement in the signs and symptoms of active PsA and axSpA. Hence, the objective of the MAXIMISE (Managing AXIal Manifestations in psorIatic arthritis with SEcukinumab) trial was to specifically evaluate the efficacy and safety of secukinumab 300 mg and 150 mg in managing axial manifestations in patients with PsA with an inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs).
Xenofon Baraliakos and associates from the Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Nordrhein-Westfalen, Germany carried out this phase 3b, a double-blind, placebo-controlled, multi-center 52-week trial which included patients above 18 years of age, all of whom were previously diagnosed with PsA and classified by ClASsification criteria for Psoriatic Arthritis (CASPAR) criteria, with spinal pain Visual Analogue Score ≥40/100 and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥4 despite the use of at least two non-steroidal anti-inflammatory drugs (NSAIDs). The authors randomized the patients in the ratio of 1:1:1 to secukinumab 300 mg, secukinumab 150 mg, or placebo weekly for 4 weeks and every 4 weeks thereafter. Patients were randomly assigned; 167 to secukinumab 300 mg, 165 to secukinumab 150 mg, and 166 to placebo. At week 12, placebo patients were re-randomized to secukinumab 300/150 mg. The primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society) response with secukinumab 300 mg at week 12. The following results were highlighted- a. Secukinumab 300 mg and 150 mg significantly improved ASAS20 response versus placebo at week 12 (63% and 66% vs 31% placebo). b. The OR (95% CI) comparing secukinumab 300 mg and 150 mg versus placebo, using a logistic regression model after multiple imputation, was 3.8 (2.4 and 6.1) and 4.4 (2.7 and 7.0; p<0.0001). Hence, the authors concluded that "Secukinumab 300 mg and 150 mg provided significant improvement in signs and symptoms of axial disease compared with placebo in patients with PsA and axial manifestations with inadequate response to NSAIDs."
