Inhibition of interleukin-17A with secukinumab gave half of psoriatic arthritis patients treated with either a low or high dose of the monoclonal antibody at least 20% improvement in the American College of Rheumatology response criteria, according to investigators in the FUTURE 1 trial published Sept. 30 in the New England Journal of Medicine.
A team of researchers led by Dr. Philip J. Mease of the Swedish Medical Center and the University of Washington, both in Seattle, assessed the efficacy of secukinumab by measuring the proportion of patients from baseline to week 24 who attained an ACR20 level of response, defined as 20% improvement in the number of tender joints (from an analysis of 78 joints), in the number of swollen joints (from an analysis of 76 joints), and in at least three of five other important domains.
Dr. Mease and his associates examined 606 patients in this double-blind, phase III study and randomly assigned them in a 1:1:1 ratio to receive IV secukinumab 10 mg/kg at weeks 0, 2, and 4, followed by subcutaneous secukinumab at a dose of either 150 mg or 75 mg every 4 weeks, or placebo.
They found that ACR20 response rates at week 24 were significantly higher in the group receiving secukinumab at doses of 150 mg (50.0%) and 75 mg (50.5%) than in those receiving placebo (17.3%). There also was significantly less radiographic progression, as measured by the change from baseline on the van der Heijde–modified total Sharp score at week 24, in the secukinumab groups, compared with patients in the placebo group. The researchers, however, also noted that infections were more common in the secukinumab groups and that four patients in the secukinumab groups had a stroke.
Read the full article here (N Engl J Med. 2015 Sept. 30;373:1329-39. doi: 10.1056/NEJMoa1412679).
