Ustekinumab and Secukinumab Safe, Efficacious for Psoriatic Arthritis

The researchers evaluated 15 clinical trials that included 17 treatments and 6004 participants. <i>Image Credit: ISM/CID</i>.
The researchers evaluated 15 clinical trials that included 17 treatments and 6004 participants. Image Credit: ISM/CID.

The following article is part of conference coverage from the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, Illinois. MPR's staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from ACR/ARHP 2018 .

CHICAGO — Among a new line of biological and targeted synthetic DMARD, ustekinumab and secukinumab have shown favorable safety and efficacy profiles for psoriasis and arthritis, respectively in patients with psoriatic arthritis (PsA), according to research presented at the 2018 ACR/ARHP Annual Meeting, held October 19-24 in Chicago, Illinois.

The researchers evaluated 15 randomized clinical trials that included 17 treatments and 6004 participants. Randomized clinical trials which examined biological and targeted synthetic DMARD in patients with PsA for ≥6 months, and individuals with active arthritis and plaque psoriasis who fulfilled the Classification Criteria for Psoriatic Arthritis were included for analysis. Network meta-analysis was used to calculate pooled odds ratios.

All treatments showed superiority to placebo in achieving 20% improvement in  American College of Rheumatology criteria (ACR 20) with the exception of clazakizumab 200mg/25mg monthly. All treatments, with the exception of abatacept 125mg weekly and clazakizumab 200mg monthly reached ACR50 criteria. Apremilast 30mg/20mg twice daily, tofacitinib, secukinumab 300mg/150mg monthly, ustekinumab, and ixekizumab, all showed superiority in achieving 75% improvement in psoriasis area and severity index (PASI75).

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Adverse events were most common with apremilast 30mg/20mg twice daily, ixekizumab, and tofacitinib 10mg twice daily. Pooled serious adverse events did not vary significantly among treatments. The network meta-analysis indicated the efficacy of secukinumab 300 mg monthly in achieving ACR20 and ACR50. Ustekinumab 90mg 12 weekly was most efficacious in achieving PASI75. The lowest likelihood for adverse events and serious adverse events was with secukinumab 75mg monthly and ustekinumab 90mg 12 weekly, respectively. Ustekinumab had the highest risk to benefit ratio and secukinumab was found to be the most efficacious in improving skin and articulations.

"Secukinumab and ustekinumab may be the safest and most efficacious [for arthritis and psoriasis, respectively] for active PsA among the new targeted synthetic and biological DMARD," concluded the study authors.

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Reference

Lu C, Wallace B, Fu W, Liu Y. Efficacy and safety of novel targeted synthetic DMARD and biological DMARD in active psoriatic arthritis: a systematic review, meta-analysis, and network meta-analysis. Presented at: ACR Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 696.

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