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Experience in using secukinumab in patients with axial psoriatic arthritis

https://doi.org/10.14412/1996-7012-2020-4-150-156

Abstract

Axial skeletal injury is observed in 25–70% of patients with psoriatic arthritis (PsA). Spondylitis frequently occurs subclinically, which leads to serious structural and functional disorders over time. An update shows that axial skeleton involvement in PsA is characterized by a more severe clinical course: these patients are observed to have a greater severity of peripheral arthritis, enthesitis, and dactylitis, skin and nail psoriasis, a higher CRP level, and worse functional status. In addition, the disease is more severe according to the patients' subjective assessment, as evidenced by questionnaires. Synthetic disease-modifying antirheumatic drugs used to treat peripheral PsA are not recommended for axial injury. When nonsteroidal anti-inflammatory drugs are ineffective, biological drugs (tumor necrosis factor-α inhibitors or interleukin-17A (IL-17A) inhibitors) should be prescribed immediately to patients with psoriatic spondylitis.
The paper describes two clinical cases demonstrating the successful use of the IL-17A inhibitor secukinumab (SEC) in patients with axial PsA (axPsA). Given the positive experience with SEC in real clinical practice, it seems reasonable to prescribe it to patients at earlier stages of axPsA.

About the Authors

E. E. Gubar
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522, Russia


Yu. L. Korsakova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522, Russia


E. Yu. Loginova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522, Russia


T. V. Korotaeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522, Russia


References

1. Coates LC, Kavanaugh A, Mease PJ, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016 May;68(5):1060-71. doi: 10.1002/art.39573. Epub 2016 Mar 23.

2. Kane D, Stafford L, Bresnihan B, FitzGerald O. A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford). 2003 Dec;42(12):1460-8. doi: 10.1093/rheumatology/keg384. Epub 2003 Oct 1.

3. Feld J, Chandran V, Gladman DD. What Is Axial Psoriatic Arthritis? J Rheumatol. 2018 Dec;45(12):1611-13. doi: 10.3899/jrheum.180802.

4. Sieper J, van der Heijde D, Landewe R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of Spondyloarthritis International Society (ASAS). Ann Rheum Dis. 2009 Jun; 68(6):784-8. doi: 10.1136/ard.2008.101501. Epub 2009 Jan 15.

5. Gubar' EE, Loginova EYu, Smirnov AV, et al. Clinical and instrumental characteristics of axial lesion in early peripheral psoriatic arthritis. (Data from the REMARKA study). Nauchno-prakticheskaya revmatologiya 2018; 56(1):34-40. (In Russ.)

6. Jadon DR, Sengupta R, Nightingale A, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis. 2017 Apr;76(4):701-7. doi: 10.1136/annrheumdis-2016-209853. Epub 2016 Dec 2.

7. Gubar' EE, Loginova EYu, Korotaeva TV, et al. Comparative characteristics of early psoriatic arthritis with and without lesions of the axial skeleton (subanalysis of the allRussian register of patients with psoriatic arthritis). Nauchno-prakticheskaya revmatologiya. 2019;57(6):636-41. (In Russ.)

8. Laiho K, Kauppi M. The cervical spine in patients with psoriatic arthritis. Ann Rheum Dis. 2002 Jul;61(7):650-2. doi: 10.1136/ard.61.7.650.

9. Mease PJ, Palmer JB, Liu M, et al. Influence of Axial Involvement on Clinical Characteristics of Psoriatic Arthritis: Analysis from the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. J Rheumatol. 2018 Oct;45(10):1389-96. doi: 10.3899/jrheum.171094.

10. Singh JA, Guyatt G, Ogdie A, et al. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019 Jan;71(1):5-32. doi: 10.1002/art.40726. Epub 2018 Nov 30.

11. Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-12. doi: 10.1136/annrheumdis-2020-217159.

12. McInnes IB, Mease PJ, Ritchlin CT, et al. Secukinumab sustains improvement in signs and symptoms of psoriatic arthritis: 2 year results from the phase 3 FUTURE 2 study. Rheumatology (Oxford). 2017 Nov 1;56(11): 1993-2003. doi: 10.1093/rheumatology/kex301.

13. Schett G, Sticherling M, Neurath MF. COVID-19: risk for cytokine targeting in chronic inflammatory diseases? Nat Rev Immunol. 2020 May;20(5):271-272. doi: 10.1038/s41577-020-0312-7.

14. Gottlieb AB, Behrens F, Nash P, et al. FRI0340 Comparison of secukinumab versus adalimumab efficacy on skin outcomes in psoriatic arthritis: 52-week results from the EXCEED study. Ann Rheum Dis. 2020;79: 763-64.

15. Reich K, Warren RB, Coates LC, et al. Long-term efficacy and safety of secukinumab in the treatment of the multiple manifestations of psoriatic disease. J Eur Acad Dermatol Venereol. 2020 Jun;34(6):1161-73. doi: 10.1111/jdv.16124. Epub 2020 Jan 7.

16. McInnes IB, Behrens F, Mease PJ, et al. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet. 2020 May 9;395(10235):1496-505. doi: 10.1016/S0140-6736(20)30564-X.

17. Baraliakos X, Coates LC, Gossec L, et al OP0235 Secukinumab improves axial manifestations in patients with psoriatic arthritis and inadequate response to NSAIDS: primary analysis of the MAXIMISE trial. Ann Rheum Dis. 2019;78:195-96.

18. Spindeldreher S, Maillere B, Correia E, et al. Secukinumab demonstrates significantly lower immunogenicity potential compared to Ixekizumab. Dermatol Ther (Heidelb). 2018 Mar;8(1):57-68. doi: 10.1007/s13555-018-0220-y. Epub 2018 Feb 1.

19. Gossec L, Smolen JS, Ramiro S, et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis. 2016 Mar;75(3):499-510. doi: 10.1136/annrheumdis-2015-208337. Epub 2015 Dec 7.

20. Baraliakos X, Gossec L, Pournara E, et al. OP0053 Secukinumab improves clinical and imaging outcomes in patients with psoriatic arthritis and axial manifestations with inadequate response to NSAIDS: week 52 results from the MAXIMISE trial. Ann Rheum Dis. 2020;79:35-6. doi:10.1136/annrheumdis2020-eular.638


Review

For citations:


Gubar EE, Korsakova YL, Loginova EY, Korotaeva TV. Experience in using secukinumab in patients with axial psoriatic arthritis. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2020;14(4):150-156. (In Russ.) https://doi.org/10.14412/1996-7012-2020-4-150-156

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)