Cosentyx and erosion progression in psoriatic arthritis

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Results of a one-year  trial utilising high-resolution peripheral quantitative computed tomography in patients with psoriatic arthritis using Cosentyx (secukinumab).

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Objectives:
This study aimed to ascertain the effect of secukinumab on erosion and enthesiophyte progression in psoriatic arthritis (PsA) by high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods:
This was a phase 4, double-blind, randomized, placebo-controlled trial. Patients with active PsA and ≥ 1 erosion in the metacarpophalangeal joints (MCPJ) 2-4 were randomised in a 1:1 ratio to subcutaneous secukinumab or placebo. HR-pQCT of the MCPJ 2-4 were performed at baseline, week 24 and week 48 The primary outcome was the changes in the volume of erosions on MCPJ 2-4 measured by HR-pQCT at 24 and 48 weeks.

Results:
Forty patients (age: 51.9±13.4 years, 20 [50%] male, disease duration: 4.7±6.7years) were recruited. Thirty-four patients who completed study treatment were included in the per-protocol analysis. At baseline, week 24 and week 48, the secukinumab group showed a significant reduction in erosion volume, whereas no changes were observed in the placebo group (change in the secukinumab group: -0.1 (-0.5, 0.0) vs: 0.0 (-0.2, 0.4) in the placebo group, p=0.004). A similar trend was observed for enthesiophyte volume changes in the secukinumab group, while no differences were noted in the placebo group (change in the secukinumab group: -0.1 (-0.8, 0.0) vs 0.0 (-0.4, 1.3) in the placebo group, p=0.067). GEE results showed that the odds ratio (OR) for enthesiophyte progression in the secukinumab group was 0.264 (95% CI: 0.080-0.878, p=0.030), while the OR for partial erosion healing in the secukinumab group was 2.882 (95% CI: 1.130 to 7.349, p=0.027).

Conclusions:
Secukinumab demonstrates a potential benefit in facilitating partial erosion repair and preventing enthesiophyte progression in PsA.

Source: onlinelibrary.wiley.com

*Funding: Early view funding unknown.

Cosentyx (secukinumab)