Patients with psoriatic arthritis (PsA) or psoriasis are at greater risk for psychological distress, including depression and suicidality. According to research results presented Sunday at the 2017 annual meeting of the American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP), patients receiving secukinumab for the treatment of those chronic conditions experienced sustained relief from anxiety and depression for as long as one year.
Secukinumab is a fully human monoclonal antibody that selectively neutralizes interleukin-17A, and it has been shown to be efficacious and safe in the treatment of PsA and moderate to severe psoriasis. Previous analyses of pooled data from phase III studies of secukinumab have shown that about 80% of patients experienced high and sustained relief from anxiety and depression with secukinumab 300 mg.
Philip J. Mease, MD, of the Swedish Medical Center and University of Washington, Seattle, and co-authors presented confirmatory data in an abstract titled “Secukinumab Treatment of Psoriatic Arthritis and Moderate to Severe Psoriasis Relieves Anxiety/Depression up to 52 Weeks: An Overview from Secukinumab Phase 3 Clinical Trials.”
The analysis used data gathered during three phase III trials: FUTURE 1 and 2, which compared SEC 150 mg to placebo in active PsA, and CLEAR, which compared secukinumab 300 mg to ustekinumab in moderate to severe psoriasis. Researchers examined results from the Anxiety/Depression dimension of the EuroQol five-dimensional (Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression) three-level questionnaire (EQ-5D-3L).
The analysis found consistently higher anxiety and depression among patients with PsA than those with moderate to severe psoriasis. However, regardless of disease type, secukinumab treatment improved anxiety and depression for as long as a year. Specifically:
- In FUTURE 1, 76 of 200 of patients with PsA (38%) reported not being anxious or depressed at baseline, and that number improved to 99 of 192 (51.6%) by week 4 and 109 of 184 (59.2%) by week 52.
- In FUTURE 2, 32 of 100 (32%) and 41 of 99 (41.4%) PsA patients treated with secukinumab 150 mg or 300 mg, respectively, reported being not anxious or depressed at baseline. At week 4, more patients reported not being anxious or depressed: 51 of 99 (51.5%) and 52 of 95 (54.7%). At week 52, the number improved a bit more, to 49 of 89 (55.1%) and 55 of 95 (57.9%).
- In the CLEAR study, 154 of 326 (47.2%) psoriasis patients receiving secukinumab 300 mg reported being not anxious or depressed at baseline. At week 4, the number increased to 238 of 322 (73.9%); at week 16, it improved to 263 of 326 (80.7%), which was sustained to week 52.