Cosentyx May Prevent Joint Structural Damage in Psoriatic Arthritis Patients

Novartis recently announced positive results from a phase 3 clinical trial demonstrating that secukinumab (Cosentyx) reduced the symptoms of psoriatic arthritis (PsA), while blocking joint structural damage, according to a press release.

The data from the FUTURE 5 study were presented at the 2017 American College of Rheumatology Annual Meeting.

PsA is a debilitating and progressive inflammatory disease. Nearly half of patients experience significant joint damage and permanent deformity as a result of the condition, according to Novartis.

Included in the study were 996 patients with PsA who were randomized to receive secukinumab 300-mg with loading dose (LD), 150-mg with LD, 150-mg without LD or placebo. At week 16, placebo patients who did not respond to therapy were switched to secukinumab and remaining patients were switched at week 24.

The primary endpoint was ACR 20 at 16 weeks, which assesses the improvement of tender and swollen joints, pain, and physical function, according to Novartis. The secondary endpoint was radiographic structural progression at weeks 16 and 24.

The investigators found that fewer patients treated with secukinumab had worsened joint structural damage compared with placebo. Approximately 88% of patients in the 300-mg cohort and 80% in the 150-mg cohort did not experience joint structural damage compared with 74% of placebo patients, according to the release.

"People living with psoriatic arthritis deal with the daily impact of pain, tender joints, as well as the potential of reduced mobility, and irreversible joint damage," said lead investigator Philip Mease, MD. "A treatment that reduces the signs and symptoms of psoriatic arthritis and addresses the disease on a structural level by slowing the progression of joint damage could offer a significant benefit for patients."

The investigators also found that secukinumab-treated patients showed reduced signs and symptoms at 16 weeks compared with placebo.

Approximately 62% of patients in the 300-mg cohort and 55% in the 150-mg cohort achieved ACR20, while 59% of patients in the 150-mg without LD achieved this goal, according to the study. Comparatively, only 27.4% of patients in the placebo cohort reached ACR20.

Additionally, Novartis reports that patients in the 300-mg and 150-mg cohorts achieved an earlier response than those in the 150-mg without LD cohort.

The investigators noted that efficacy was higher among patients who were not previously treated with anti-TNF drugs, according to the release.

Currently, secukinumab is approved to treat patients with PsA, ankylosing spondylitis, and psoriasis.

"With nearly 1,000 patients included in the study, FUTURE 5 is the largest randomized controlled trial of a biologic conducted to date in psoriatic arthritis," said Vas Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis. "The results are encouraging as they provide important information about the ability of Cosentyx to address key areas of concern for physicians when managing the symptoms and the underlying progression of joint structural damage of psoriatic arthritis.”