Rheumatology Xagena

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Psoriatic arthritis: Secukinumab provides rapid and sustained pain relief over 2 years

Pain is one of the most important domains affecting health-related quality of life ( HRQoL ) in patients with psoriatic arthritis ( PsA ).
Secukinumab ( Cosentyx ) has demonstrated rapid and sustained improvements in signs and symptoms, including HRQoL, among patients with active psoriatic arthritis.

This analysis has evaluated the effect of Secukinumab on patient-reported pain in psoriatic arthritis through 104 weeks of treatment.

Pain was assessed through week 104 using clinically relevant measures, including change from baseline in a pain visual analog scale ( VAS ) and Short Form-36 ( SF-36 ) bodily pain domain scores; proportion of patients reporting improvements equal to or better than minimum clinically meaningful differences in the pain VAS and SF-36 bodily pain domain scores; and proportion of patients with no, moderate, or extreme pain / discomfort measured by the EuroQoL 5-Dimension 3-Level Questionnaire ( EQ-5D-3 L ) pain item scores.
Correlations of pain measures were analyzed using Pearson's correlation coefficient.
Pre-specified analyses of TNF-naïve patients and patients who stopped TNF-inhibitors ( TNFis ) due to inadequate responses or safety / tolerability ( TNF-IR patients ) were performed using as-observed data.

Mean improvements from baseline in pain VAS scores were greater with Secukinumab versus placebo by week 3 ( - 16.9; P less than 0.0001 with Secukinumab 300 mg and - 12.6; P less than 0.05 with Secukinumab 150 mg ) and sustained through week 104.

SF-36 bodily pain domain scores were significantly greater with 300 mg Secukinumab and Secukinumab 150 mg versus placebo by week 4 ( 16.2 and 16.3, respectively; P less than 0.0001 for both ), and these changes were maintained through week 104.

With both Secukinumab 300 mg and Secukinumab 150 mg, improvements equal to or better than the minimum clinically meaningful differences in pain VAS and SF-36 bodily pain were significant versus placebo at week 3 and week 4, respectively.

At week 4, 15%, 9%, and 5% of patients receiving Secukinumab 300 mg, Secukinumab 150 mg, and placebo, respectively, reported no pain / discomfort measured by EQ-5D-3 L; these proportions increased to week 104 with both Secukinumab doses.

Similarly, improvements in pain measures were significant in both TNF-naïve and TNF-IR patients.

In conclusion, Secukinumab has provided rapid and sustained pain relief in psoriatic arthritis over 2 years of treatment.
Improvements in pain were reported regardless of prior exposure to TNFis. ( Xagena )

McInnes IB et al, Arthritis Res Ther 2018;20(1):113. doi: 10.1186/s13075-018-1610-3