At EULAR today, controversy may have been stoked by a couple of posters that compared the new treatment for PsA – secukinumab – against other approved biologics and apremilast.
Phase 3 studies comparing secukinumab to placebo have shown that the drug is safe and efficacious for the management of PsA with response to musculoskeletal manifestations seemingly similar to – and skin response being superior to – TNFi (numerically). The FUTURE 1 and 2 studies, however, had no active comparator. The following two abstracts have tried to formally make indirect comparisons.
McInnes et al. (#THU0437) conducted a systematic literature review and network meta-analysis comparing secukinumab to all licensed biologics and apremilast in adults with active PsA who had failed conventional DMARD therapy. The analyses were performed in biologic-naïve, biologic-experienced, and mixed populations at week 16 for ACR responses and at weeks 12–16 for PASI responses.
The results showed that secukinumab was superior to ustekinumab and apremilast with regard to ACR20, 50 and 70 responses, and had comparable response rates vs. TNFi.
Further, Nash et al. indirectly compared patient-level data from the FUTURE 2 trial (subcutaneous secukinumab vs. placebo) to the ADEPT trial data with adalimumab (#THU0448) using matching-adjusted indirect comparison. They showed that secukinumab 150 and 300 mg had statistically significantly higher responses vs. adalimumab for ACR 20, and secukinumab 300 mg vs. adalimumab for ACR 50.
The stage is now set for a direct comparison between secukinumab and adalimumab in adults with active PsA!
Dr. Chandran is a rheumatologist and clinician-scientist, an Assistant Professor of Medicine & Laboratory Medicine and Pathobiology at the University of Toronto, an affiliate scientist at the Krembil Research Institute, a staff physician at the University Health Network and Mount Sinai Hospitals, and an associate member of the graduate faculty at the Institute of Medical Science. He co-directs the Psoriatic Arthritis Program at the University Health Network.View Full Bio