Subcutaneous secukinumab improved clinical signs and symptoms and inhibited radiographic structural progression at 24 weeks in patients with psoriatic arthritis (PsA), according to the results of the randomized, double-blind, phase III FUTURE 5 study published in the Annals of the Rheumatic Diseases.

Philip Mease, MD, clinical professor at the University of Washington and director of rheumatology clinical research, Swedish Medical Center, Seattle, Washington, and colleagues randomly assigned 996 patients with active PsA to receive subcutaneous secukinumab 300 mg or 150 mg with a loading dose, 150 mg without a loading dose, or placebo. All groups received secukinumab or placebo at baseline; at 1, 2, and 3 weeks; and then every 4 weeks thereafter. The primary endpoint was the proportion of patients achieving a 20% response according to American College of Rheumatology (ACR20) at 16 weeks.

Significantly more patients achieved an ACR20 response at 16 weeks with secukinumab 300 mg with a loading dose (62.6%), 150 mg with a loading dose (55.5%), or 150 mg without a loading dose (59.5%) compared with placebo (27.4%; P <.0001 for all). Secukinumab significantly inhibited radiographic progression, as measured by van der Heijde-modified total Sharp score compared with placebo (P <.01 for 300 mg with a loading dose and 150 mg without a loading dose, and P <.05 for 150 mg with loading dose). Adverse event rates at 24 weeks were similar in all treatment groups, and no deaths or new safety signals occurred.

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The authors concluded that patients receiving secukinumab benefited from a loading dose regimen, regardless of dose. However, they also noted that the study was limited, in that it was not designed to identify a difference between doses or to assess differences in response according to previous anti-tumor necrosis factor inhibitor use.

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Mease P, van der Heijde D, Landewe R, et al. Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study [published online March 17, 2018]. Ann Rheum Dis. doi:10.1136/annrheumdis-2017-212687