Relationship of radiographic progression status to low disease activity in patients with psoriatic arthritis receiving secukinumab treatment for two years

Objective To examine relationships between radiographic progression and achievement of low disease activity (LDA) or remission at week 104 in patients with psoriatic arthritis (PsA) receiving secukinumab. Methods This post hoc analysis included data from patients with active PsA enrolled in the phase 3 FUTURE 5 study (NCT02404350). Patients were pooled by treatment received at week 104 (secukinumab 300 mg with loading dose [LD], secukinumab 150 mg with LD, or secukinumab 150 mg without LD) and grouped by radiographic progression status. Radiographic progression was defined as change from baseline to week 104 in van der Heijde modified Total Sharp Score >0.5. Efficacy was assessed by achievement of minimal disease activity (MDA), very low disease activity (VLDA), and Disease Activity Index for Psoriatic Arthritis (DAPSA) LDA or remission. Demographics and clinical characteristics associated with radiographic progression at week 104 were identified by logistic regression analyses. Results Of the 541 patients included in this analysis, 457 (84.5%) were radiographic nonprogressors and 84 (15.5%) were radiographic progressors. Higher proportions of nonprogressors achieved MDA, VLDA, and DAPSA LDA and remission at week 104 than progressors. Radiographic progression at week 104 was associated with older age and higher baseline high-sensitivity C-reactive protein level, whereas nonprogression was associated with 300 mg secukinumab (vs 150 mg secukinumab without LD), no prior exposure to tumour necrosis factor inhibitors, and lower body mass index. Conclusion Patients without radiographic progression through 2 years of secukinumab treatment had greater achievement of LDA states at week 104 than patients with radiographic progression. Trial registration ClinicalTrials.gov; NCT02404350