Efficacy, Safety, and Tolerability of Secukinumab in Psoriatic Arthritis: A Systematic Review and Meta-Analysis.

Abstract

Objective: To evaluate the efficacy and safety of secukinumab in patients with active psoriatic arthritis (PsA) through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Data sources: A comprehensive literature search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov was conducted from inception until February 2026 to identify relevant RCTs.

Study selection and data extraction: Eligible studies included randomized, placebo-controlled trials assessing secukinumab in adults with active PsA. Two independent reviewers screened studies, extracted data on clinical efficacy (American College of Rheumatology [ACR] 20/50 responses, Health Assessment Questionnaire-Disability Index [HAQ-DI]) and safety outcomes (overall adverse events [AEs], infections, and treatment discontinuation) and assessed the risk of bias.

Data synthesis: Pooled analyses demonstrated that secukinumab significantly improved ACR20 and ACR50 response rates and reduced HAQ-DI scores compared with placebo. Dose-related trends suggested greater efficacy with the 300 mg regimen for selected outcomes. Safety analysis showed no significant increase in overall AEs, upper respiratory tract infections, or discontinuations compared with placebo.

Relevance to patient care and clinical practice: These findings support secukinumab as an effective and well-tolerated biologic therapy, particularly for patients with an inadequate response to conventional disease-modifying antirheumatic drugs or tumor necrosis factor inhibitors, thereby facilitating individualized treatment strategies.

Conclusions: Secukinumab is associated with significant clinical and functional benefits and demonstrates a favorable safety profile, reinforcing its role in optimizing long-term disease control in active PsA.