Enthesitis in patients with psoriatic arthritis treated with secukinumab or adalimumab: a post hoc analysis of the EXCEED study

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Kaeley,Gurjit S.
Schett,Georg
Conaghan,Philip G.
McGonagle,Dennis
Behrens,Frank
Goupille,Philippe
Gaillez,Corine
Parikh,Bhumik
Bakewell,Catherine

LTHT Author

Conaghan, Philip
McGonagle, Dennis

LTHT Department

NIHR Leeds Biomedical Research Centre
Rheumatology

Non Medic

Publication Date

2024

Item Type

Article

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Subject

Subject Headings

Abstract

Objectives To evaluate enthesitis treatment response, including time to resolution and data from multiple enthesitis instruments, in patients with PsA treated with secukinumab or adalimumab for 52?weeks. Methods In this post hoc analysis of the EXCEED study, patients receiving secukinumab 300?mg or adalimumab 40?mg per the label were grouped by presence or absence of baseline enthesitis based on the Leeds Enthesitis Index (LEI) and the Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC). Efficacy was assessed according to several enthesitis-related instruments using non-responder imputation for the achievement of enthesitis resolution (LEI/SPARCC?=?0), Kaplan朚eier analysis for time to resolution, and as-observed data for other outcomes. Results Enthesitis was present at baseline in 498 of 851 patients (58.5%) as assessed by LEI and in 632 of 853 patients (74.1%) as assessed by SPARCC. Patients with baseline enthesitis generally presented with greater disease activity. Similar proportions of patients receiving secukinumab or adalimumab achieved resolution of LEI and SPARCC at weeks 24 (secukinumab: LEI/SPARCC, 49.6%/45.8%; adalimumab: LEI/SPARCC, 43.6%/43.5%) and 52 (secukinumab: LEI/SPARCC, 60.7%/53.2%; adalimumab: LEI/SPARCC, 55.3%/51.4%), with comparable mean time to enthesitis resolution. Improvements were similar for both drugs at individual enthesitis sites. Resolution of enthesitis with secukinumab or adalimumab was associated with improvements in quality of life at week 52. Conclusion Secukinumab and adalimumab showed similar efficacy, including time to resolution, with respect to resolution of enthesitis. Inhibition of IL-17 with secukinumab reduced clinical enthesitis similarly to TNF-? inhibition. Trial registration ClinicalTrials.gov , NCT02745080

Journal

Rheumatology