Secukinumab is currently licensed in the UK for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. It is currently in Phase III development for psoriatic arthritis but applications for approval of its use in this indication have not yet been filed.
The authors of a related Comment note that radiological progression was not assessed in this study. As erosion and new bone formation are prominent features of the structural consequences of psoriatic arthritis, they recommend that future studies with this class of drug investigate this issue in detail. They note that the safety results seem reassuring, with similar overall rates of adverse events and serious adverse events with secukinumab and placebo. The outcomes of a subgroup analysis according to history of anti-TNF treatment are reported, suggesting a lower response rate in patients who had received ≤ anti-TNFs when compared to anti-TNF-naïve patients. This is however limited by the small number of patients in each group.
The Comment article welcomes the results of this study but notes that many questions still remain about the optimal treatment of patients with psoriatic arthritis. Although many treatments have proven efficacy, there is little comparative data available and no evidence to guide the sequencing of drugs or which therapies are best for certain patient subgroups.