Resolution of synovitis and arrest of catabolic and anabolic bone changes in patients with psoriatic arthritis by IL-17A blockade with secukinumab: results from the prospective PSARTROS study

Kampylafka, Eleni; d’Oliveira, Isabelle; Linz, Christina; Lerchen, Veronika; Stemmler, Fabian; Simón, David; Englbrecht, Matthias; Sticherling, Michael; Rech, Jürgen; Kleyer, Arnd; Schett, Georg; Hueber, Axel J.

doi:10.1186/s13075-018-1653-5

Cited by 63 publications

(56 citation statements)

References 32 publications

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“…These data show that inhibition of IL-17A by secukinumab leads to profound changes in general, physical, and mental health perception of PsA patients in addition to the objective improvement in signs and symptoms and imaging findings of inflammation, which have been reported previously [5,6]. While the effects of secukinumab on pain and physical function observed in established PsA are not surprising and have already been observed in the large phase 3 studies [7][8][9], in which ACR responses comprising pain and function are used as outcomes, the substantial effects of secukinumab treatment on other PROs that are not directly related to pain and physical function, such as social functioning, vitality, mental health, and emotional role limitation are interesting and suggest a much deeper modification of the health state of PsA patients than previously considered.…”

Section: Discussionsupporting

confidence: 82%

“…Patients from the IVEPsA study [6] on very early PsA (N = 20) and the PSARTROS [5] study on established PsA (N = 20) were included in this analysis. The very early PsA patients of the IVEPsA study were required to fulfill the following criteria: (i) presence of moderate to severe psoriasis (PASI score > 6) or scalp or nail involvement; (ii) absence of present or past joint swelling, active enthesitis, or dactylitis; and (iii) presence of subclinical inflammatory changes in magnetic resonance imaging (MRI) or erosive changes in MRI or high-resolution peripheral quantitative computed tomography (HR-pQCT).…”

Section: Study Populationmentioning

confidence: 99%

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Secukinumab leads to shifts from stage-based towards response-based disease clusters—comparative data from very early and established psoriatic arthritis

et al. 2020

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Background Limited information exists about the very early forms of psoriatic arthritis. In particular, differences and responsiveness of patient-reported outcomes (PROs) in very early as compared to established PsA have not been investigated to date. Methods Cross-sectional and prospective longitudinal evaluation of PROs related to pain (VAS), physical function (HAQ-DI, SF-36 physical), mental function (SF-36 mental), impact of psoriatic skin (DLQI), joint (PsAID), and global disease (VAS) in two small prospective observational studies on secukinumab 300 mg over 6 months in very early disease patients (IVEPSA study, N = 20) and established PsA (PSARTROS study, N = 20). Cluster analysis was performed at baseline and 24-weeks of follow-up. Results While responses in pain and physical activity-related PROs to secukinumab were more pronounced in established PsA than a very early disease, effects on PROs related to general health perception, as well as those related to emotional and mental well-being, were modified in a similar way in very early disease and established PsA. Cluster analysis based on global disease activity and PROs showed that baseline clusters reflected very early disease and established PsA, while after secukinumab treatment these clusters were abolished and new clusters based on differential responses to physically and mentally oriented PROs formed. Conclusions Inhibition of IL-17A by secukinumab leads to comprehensive improvement of general health perception and mental well-being in very early and established PsA, while overall responses in pain and physical activity are more pronounced in established disease. Most importantly, treatment restructures the original patients’ clusters based on disease stage and leads to the formation of new clusters that reflect their response in physical and mental-orientated PROs. Trial registration NCT02483234, registered 26 June 2015, retrospectively registered.

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Section: Discussionsupporting

confidence: 82%

Section: Study Populationmentioning

confidence: 99%

Secukinumab leads to shifts from stage-based towards response-based disease clusters—comparative data from very early and established psoriatic arthritis

et al. 2020

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“…Clinical data in patients with PsA show a significant reduction in joint radiographic progression with IL-17A inhibitors versus placebo in the short-term and low long-term rates of radiographic progression 13 14 129. Furthermore, recent data from the PSARTROS study showed no progression of catabolic and anabolic bone changes in the joints of patients with PsA treated with secukinumab for 24 weeks 130…”

Section: Role Of Il-17a In Spamentioning

confidence: 99%

The role of IL-17A in axial spondyloarthritis and psoriatic arthritis: recent advances and controversies

et al. 2019

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Although the pathogenic mechanisms underlying axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are not fully elucidated, several lines of evidence suggest that immune responses mediated by interleukin 17A (IL-17A) play a pivotal role in both diseases. This is best highlighted by the significant clinical efficacy shown with inhibitors of IL-17A in treating axSpA and PsA. Nevertheless, a number of knowledge gaps exist regarding the role of IL-17A in the pathophysiology of spondyloarthritis in man, including its cellular origin, its precise role in discrete disease processes such enthesitis, bone erosion, and bone formation, and the reasons for the discrepant responses to IL-17A inhibition observed in certain other spondyloarthritis manifestations. In this review, we focus on the latest data from studies investigating the role of IL-17A in ankylosing spondylitis (AS) and PsA that build on existing and emerging scientific knowledge in the field. Key remaining research questions are also highlighted to guide future research.

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“…These results suggest that psoriasis patients who will develop PsA soon after diagnosis of psoriasis could be identified by unspecific arthritic symptoms and should therefore receive rheumatological care. Recent evidence suggests that early intervention treatment of PsA with biologic disease-modifying anti-rheumatic drugs (DMARDs) halts the progression of bone changes and decreases synovial inflammation [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis

Rech

Sticherling

Stoessel³

et al. 2020

Rheumatology Advances in Practice

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Abstract Objective Psoriasis (PsO) is a systemic inflammatory disease often accompanied by comorbid diseases, including metabolic syndrome, cardiovascular diseases and depression. Up to 41% of PsO patients develop psoriatic arthritis (PsA), making it one of the most relevant manifestations. A large health claims data set was analyzed to determine the rate of PsA development in PsO patients. Furthermore, comorbid disease profiles of PsO patients with or without PsA were compared, and potential risk factors for the development of PsA were identified. Methods This was a non-interventional, retrospective analysis of anonymized insurance health claims data using a subset of the Institute of Applied Health Research Berlin (InGef) database. The primary outcome was the prevalence and incidence of diagnosed PsA among PsO patients in Germany. Risk factors for the development of PsA in PsO patients were determined by conditional logistic regression analysis. Results The cumulative percentage of patients with existing PsO developing concomitant PsA (PsO–PsA) over 4 years was 3.44% with a mean time to diagnosis of PsA of 1.5 years. PsO patients diagnosed with acute rheumatism (odds ratio: 2.93, 95% CI=1.76–4.86; p= < 0.001) or “pain in unspecific joints” (odds ratio: 1.74, 95% CI=1.01–2.99; p=0.047) showed an increased risk to develop PsA later on. Interestingly, less than half of the patients with concomitant PsA consulted a rheumatologist. Conclusions Unspecific arthritic symptoms likely precede PsA diagnoses and can develop soon after PsO onset with accumulating risk over time. There is a high unmet need for early rheumatologic assessment of PsO patients.

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Resolution of synovitis and arrest of catabolic and anabolic bone changes in patients with psoriatic arthritis by IL-17A blockade with secukinumab: results from the prospective PSARTROS study

Cited by 63 publications

References 32 publications

Secukinumab leads to shifts from stage-based towards response-based disease clusters—comparative data from very early and established psoriatic arthritis

Secukinumab leads to shifts from stage-based towards response-based disease clusters—comparative data from very early and established psoriatic arthritis

The role of IL-17A in axial spondyloarthritis and psoriatic arthritis: recent advances and controversies

Psoriatic arthritis epidemiology, comorbid disease profiles and risk factors: results from a claims database analysis

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