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‘Reassuring’ Long-Term Results With Cosentyx in PsA

MADRID — Subcutaneous secukinumab (Cosentyx) provided sustained inhibition of radiographic progression, as well as sustained clinical responses, through 2 years of treatment in patients with active psoriatic arthritis (PsA), a researcher reported here.

In a follow-up of the FUTURE-5 trial, 89.5% of patients treated with 300 mg of secukinumab had <0.5 deterioration in their modified Total Sharp Score (TSS), according to Philip Mease, MD, of the Swedish Medical Center in Seattle.

The ≤0.5 score on the assessment tool indicated little damage progression in the joints has occurred in these patients, he reported at the European Congress of Rheumatology, the European League Against Rheumatism (EULAR) annual meeting.

Mease also reported that 82.3% of patients assigned to the 150 mg dose of secukinumab exhibited no deterioration in their radiological examination >0.5 on the modified TSS, and 81.1% of patients on 150 mg of secukinumab without a loading dose also achieved that same milestone after 2 years of therapy.

FUTURE-5 results were first reported at the 2017 American College of Rheumatology meeting in San Diego, and published in 2018. The trial tested three doses of secukinumab — 300 mg with loading dosage (LD), 150 mg with LD, 150 mg without LD — against placebo at 16 weeks. All agent doses of secukinumab were significantly superior than placebo at that time point. Placebo patients were then re-randomized to doses of secukinumab for the duration of the 104-week trial, with assessment at 112 weeks.

Mease stated that secukinumab treatment was associated with 77% to 79.4% of patients achieving an American College of Rheumatology 20 (ACR20) improvement in their joint and pain symptoms after 2 years of treatment. The ACR50 level of improvement was achieved by 51.9% to 57.7% of the patients treated with the agent, he added.

In terms of skin issues associated with PsA, 59.2% to 70.1% of patients achieved a Psoriasis Area and Severity Index (PASI90) score, while 40.7% to 49.5% of patients achieved a PASI 100 score.

The 24-month results also showed improvement in enthesitis and dactylitis. Specifically, 82.8% to 89.3% of patients treated with secukinumab with baseline dactylitis saw the condition resolve after 2 years. And 69.5% to 78% of patients with baseline enthesitis had that condition resolve after 104 weeks of treatment with secukinumab, Mease said.

Finally, 2 years of treatment with secukinumab “was well tolerated with a safety profile consistent with previous reports.” Serious adverse events occurred in 131 patients for a rate of 7.9 per 100 patients-years; 5.6% of patients discontinued treatment on study due to adverse events, he reported.

“Joint damage in psoriatic arthritis is associated with disability as it is in rheumatoid arthritis,” commented John Isaacs, MBBS, PhD, chair of the EULAR Abstract Selection Committee.

“What this abstract showed us was that treatment with secukinumab appeared to prevent joint damage for at least 2 years,” Isaacs told MedPage Today. “That is an important observation. It is reassuring that treatment with secukinumab continues to be effective.”

The study was supported by Novartis.

Mease disclosed relevant relationships with AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Lilly, Novartis, Pfizer, SUN, UCB, Galapagos, Gilead Sciences, and Genentech.

Isaacs disclosed relevant relationships with Pfizer, Abbvie, Roche, Galvani, Merck, Gilead, Eli Lilly, Amgen, Janssen, Celltrion, and the NAPP.


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