Clinical Edge Journal Scan

TNFi may improve ultrasound-confirmed active enthesitis more effectively than secukinumab


 

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Recommended Reading

Entheseal ultrasound by dermatologists may not be effective for screening PsA
MDedge Rheumatology
IV secukinumab, alternative to self-injections, reaches primary endpoints in PsA, axSpA
MDedge Rheumatology
Commentary: Examining DMARD Use in PsA, December 2023
MDedge Rheumatology
Nail psoriasis in Black patients often overlooked
MDedge Rheumatology
Bimekizumab shows promise for palmoplantar pustular psoriasis
MDedge Rheumatology
How to Reduce Cardiovascular Morbidity and Mortality in Psoriasis and PsA
MDedge Rheumatology
Meta-analysis highlights differential response to treatment in male vs female patients with PsA
MDedge Rheumatology
Real-world study demonstrates long-term efficacy of secukinumab in PsA
MDedge Rheumatology
Hyperuricemia associated with more comorbidities in PsA
MDedge Rheumatology
Non-trough serum drug levels can identify TNFi treatment responders in PsA
MDedge Rheumatology