For patients with psoriatic arthritis (PsA), a chronic disease characterized by a form of inflammation of the skin and joints, the optimal aim of treatment is very low disease activity (VLDA) or remission. Minimal disease activity (MDA) and low disease activity (LDA) are also good results of treatment.
At the 2017 annual meeting of the American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP), a team presented results from an exploratory analysis that assessed the proportion of patients who reached those treatment aims with secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A.
To measure disease activity states, the researchers, led by Laura C. Coates, PhD, of the University of Oxford, Leeds, Great Britain, used MDA measurements and the Disease Activity index for PSoriatic Arthritis (DAPSA). They used two-year data from the FUTURE 2 study: two secukinumab arms (approved doses of 300 mg and 150 mg) as well as the placebo group. Baseline characteristics were similar among treatment groups. The analysis sought to identify the proportion of patients who reached DAPSA remission or LDA, as well as those who reached either MDA or VLDA at weeks 16 and 104.
In the overall population, a higher proportion of secukinumab-treated patients achieved the above goals than those who received placebo. Specifically, at week 16 in the overall population, 10% and 14% of patients treated with secukinumab 150 or 300 mg achieved remission according to DAPSA, respectively. Those achieving VLDA were 6% and 8%; those having LDA were 44% and 42%, those reaching MDA were 23% and 28%. Responses were sustained through week 104.
In addition, patients receiving secukinumab who achieved remission or VLDA saw complete resolution of tender joints, swollen joints, and enthesitis (inflammation of the entheses, where tendons or ligaments insert into bone). That group also had a higher proportion of skin clearance and better scores on the Patient Global Assessment and the Health Assessment Questionnaire.