Response to Secukinumab Treatment in Active Psoriatic Arthritis Patients- Single Center Experience

Abstract

Objectives: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects peripheral joints, axial skeleton and enthesis, nail and skin. T helper-17 cells and Interleukin-17 (IL-17) play a major role in PsA pathogenesis. Secukinumab is a fully human monoclonal immunoglobulin G1 antibody that neutralizes IL-17A which is used for the treatment of moderate/severe psoriasis and PsA. In this study, we aimed to evaluate the response rates of PsA patients, who were followed up at Ankara University Faculty of Medicine, Department of Rheumatology, Policlinic of Biological Drug at the 16th week of secukinumab treatment. Materials and Methods: In this retrospective study, 18-year-old and older PsA patients, who were diagnosed according to the Classification Criteria for Psoriatic Arthritis and who were started to secukinumab treatment from May 2018 to December 2019, were enrolled. The disease activity indices at the beginning and at the 16th week of the secukinumab treatment were analyzed. A p-value of <0.05 was accepted as statistically significant Results: A total of 16 PsA patients were included in the study. There was a statistically significant decrease in tender and swollen joint counts at the beginning of the treatment and 16th week of the treatment. There was also a significant difference in 28 joint disease activity scores with erythrocyte sedimentation rate and 28 joint disease activity scores with C-reactive protein and Bath ankylosing spondylitis disease activity index between two groups (p=0.008, p=0.003, p=0.021, respectively). Conclusion: In this study, a decrease in disease activity markers was detected in PsA patients in whom secukinumab was initiated in our clinic compared to the initiation of treatment at the 16th week of treatment. Considering PsA a severe form of arthritis causing joint damage and functional disability, secukinumab promises favorable outcome for the treatment of PsA. Key Words: Inflammation, Psoriatic Arthritis, Secukinumab

Keywords

• Inflammation
• Psoriatic Arthritis
• Secukinumab

Aktif Psöratik Artrit Hastalarının Secukinumab Tedavisine Yanıtlarının Değerlendirilmesi- Tek Merkez Deneyimi

Abstract

Amaç: Psöriatik artrit (PsA); periferal artrit, aksiyel tutulum, entezit, deri ve tırnak tutulumları ile karakterize kronik enflamatuvar bir hastalıktır. Patogenezinde T-helper 17 hücreler ve bu hücrelerin esas sitokini olan interlökin-17 (IL-17) yer almaktadır. Secukinumab, tamamen insan monoklonal IL-17A inhibitörü olup orta ve şiddetli psöriasis ve PsA tedavisinde endikedir. Bu çalışmada Ankara Üniversitesi Tıp Fakültesi Romatoloji Anabilim Dalı, Biyolojik İlaç Polikliniği’nde PsA tanısı ile takip edilip secukinumab tedavisi başlanan hastaların tedavi öncesi ve tedavinin 16. haftasında tedaviye yanıt oranlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmaya Mayıs 2018 - Aralık 2019 tarihleri arasında secukinumab tedavisi başlanmış 18 yaş ve üzeri ve Classification Criteria for Psoriatic Arthritis kriterlerine göre göre PsA tanısı almış hastalar dahil edilmiştir. Hastaların secukinumab başlama anında hastalık aktivite değerleri ile tedavinin 16. haftasındaki değerleri kaydedilmiştir. P-değerinin <0,05 olması istatistiksel olarak anlamlı olarak kabul edilmiştir. Bulgular: Çalışmaya toplam 16 PsA hastası dahil edilmiştir. Tedavinin on altıncı haftasında hem hassas hem de şiş eklem sayılarında istatistiksel olarak anlamlı azalma görülmüştür. Yine tedavi öncesi ve tedavinin 16. haftasında bakılan 28 eklem hastalık aktivite skoru- eritrosit sedimentasyon hızı, 28 eklem hastalık aktivite skoru- C-reaktif protein ve Ankilozan spondilit hastalık aktivite indeksi ile değerlendirilen hastalık aktivite skorlarında istatistiksel olarak anlamlı gerileme tespit edilmiştir (sırasıyla p=0,008, p=0,003, p=0,021). Sonuç: Bu çalışmada, kliniğimizde secukinumab başlanan PsA hastalarında tedavinin 16. haftasında tedavi başlangıcına göre hastalık aktivite belirteçlerinde azalma tespit edilmiştir. Eklem hasarına ve fonksiyonel kısıtlılığa yol açan bir artrit olan PsA’da secukinumab etkili ve güvenilir bir şekilde kullanılabilecek bir tedavi seçeneğidir. Anahtar Kelimeler: Enflamasyon, Psöriatik Artrit, Secukinumab

Keywords

• Enflamasyon
• Psöriatik Artrit
• Secukinumab

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