Secukinumab Improves Certain PROs Equally in Patients With Early and Established PsA

Both patients with early and established psoriatic arthritis (PsA) have similar improvements in general health and mental well-being after treatment with secukinumab, according to research published in Arthritis Research & Therapy. However, improvements in pain and physical activity were more pronounced in patients with established disease.

In general, patients with immune-mediated and inflammatory disease see their quality of life considerably impaired. Patients with PsA have their quality of life impaired at multiple levels since they have a skin and joint disease. Patient-reported outcomes (PROs) can be a valuable way to understand the potential of therapy to improve quality of life, the authors explained.

“The use of PROs in the evaluation of psoriatic disease can give additional insights, since physician-based outcome measures prioritize the biomedical dimension of diseases while not fully incorporating the patients’ experience,” they wrote.

In total, there were 40 patients: 20 in the IVEPsA study, which evaluated very early PsA, and 20 in the PSARTROS study, which analyzed established PsA. All of the patients received secukinumab 300 mg subcutaneously once a week for the first 4 weeks and then once monthly for a total of 24 weeks. Nineteen of the patients with very early PsA and 17 of the patients with established PsA completed the study.

The researchers found that changes in PROs related to pain and physical function were more pronounced in the patients with established PsA compared with the patients with very early PsA, “since the burden of joint disease is higher in these individuals.” When it came to the more global PROs, such as the global patient visual analog scales (VAS) and general health perception, or PROs related to emotional and mental well-being, such as social functioning and mental health, the effects were similar between the 2 groups of patients.

The researchers also analyzed which PROs differ among the patients with established PsA who reached minimal disease activity (MDA) and those who did not. The patients who reached MDA had significantly higher improvement in VAS pain, VAS global disease activity, Health Assessment Questionnaire Disability Index, 36-Item Short Form Survey (SF-36) physical component score, SF-36 physical functioning, bodily pain, and Psoriatic Arthritis Impact of Disease Questionnaire.

The small number of patients in the study limited the power of it, the authors noted. Additionally, the follow-up time of 6 months is short. However, they said the findings show the importance of interleukin (IL)-17A inhibition.

“These data show that inhibition of IL-17A by secukinumab leads to profound changes in general, physical, and mental health perception of PsA patients in addition to the objective improvement in signs and symptoms and imaging findings of inflammation, which have been reported previously,” the authors wrote.

Reference

Kampylafka E, Tascilar K, Lerchen V, et al. Secukinumab leads to shifts from stage-based towards response-based disease clusters-comparative data from very early and established psoriatic arthritis. Arthritis Res Ther. 2020;22(1):207. doi:10.1186/s13075-020-02268-y