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Published online: 14 June 2016
© Springer International Publishing Switzerland 2016
Abstract Secukinumab (Cosentyx®) is a high affinity, human monoclonal antibody targeted against interleukin (IL)-17A. It is the first-in-class anti-IL-17 agent, initially approved for the treatment of plaque psoriasis, and more recently for the treatment of ankylosing spondylitis and psoriatic arthritis. This article reviews the therapeutic efficacy of subcutaneous secukinumab in the treatment of psoriatic arthritis, as well as discussing the tolerability and pharmacological properties of the drug. Phase III clinical trial data demonstrated that, compared with placebo, subcutaneous secukinumab was efficacious in improving the signs and symptoms of psoriatic arthritis in patients with active disease despite previous treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or disease-modifying anti-rheumatic drugs (DMARDs). In addition, secukinumab treatment was associated with significant improvements in patient-reported measures of physical functioning and health-related quality of life. Secukinumab is generally well tolerated, with the most common adverse events being mild to moderate, non-serious infections, such as upper respiratory tract infections and nasopharyngitis. In conclusion, although longer-term and comparative data are lacking, current clinical data indicate that secukinumab is efficacious and well tolerated in the treatment of psoriatic arthritis, and it thus provides a useful treatment alternative to tumour necrosis factor inhibitors and other targeted DMARDs.
1 Introduction
Psoriatic arthritis is a chronic and heterogeneous inflammatory disease characterized by synovitis, enthesitis, dactylitis and/or spondylitis [1-3]. The majority of patients with psoriatic arthritis also have psoriasis, with skin disease typically preceding the manifestation of joint disease [1, 2, 4, 5]. Psoriatic arthritis affects an estimated 0.3-1.0 % of the general population [6] (and approximately 20-30 % of patients with psoriasis [5]), and can result in significant functional disability and impaired health-related quality of life (HR-QoL) [2, 6].
Conventional pharmacological treatment options for psoriatic arthritis include non-steroidal anti-inflammatory drugs (NSAIDs), synthetic disease-modifying anti-rheumatic drugs [DMARDs] (e.g. methotrexate) and biological agents such as the tumour necrosis factor (TNF) inhibitors (e.g. etanercept, infliximab, adalimumab) [7-9]. TNF inhibitors in particular have greatly improved the clinical outcomes for patients with psoriatic arthritis [5, 10]. However, a substantial proportion of patients have an inadequate response to these agents because of drug tolerability issues, lack of efficacy or loss of efficacy over time [2, 10].
Over recent years, growing understanding of...