Quantification of pre-existing radiographic damage and its relationship with joint activity and long-term clinical outcomes with secukinumab therapy in patients with psoriatic arthritis

Arthritis Research & Therapy

Research

Joseph F. Merola¹  Georg Schett²  Bruce Kirkham³  Ana-Maria Orbai⁴  Désirée van der Heijde⁵  Gregory Ligozio⁶  Xuan Zhu⁶  David A. James⁶  Luminita Pricop⁶  Philip Mease⁷  Christopher Ritchlin⁸ 

[1] Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany;Guy’s & St Thomas’ NHS Foundation Trust, London, UK;John Hopkins Arthritis Center, Baltimore, MD, USA;Leiden University Medical Centre, Leiden, the Netherlands;Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA;Swedish Medical Centre, Providence St Joseph Health and University of Washington, 601 Broadway, Suite 600, 98122, Seattle, WA, USA;University of Rochester, Rochester, NY, USA;

关键词: Psoriatic arthritis;    Radiographic damage;    Bone erosion;    Joint space narrowing;    Minimal disease activity;   

DOI  :  10.1186/s13075-022-02944-1

 received in 2022-02-08, accepted in 2022-11-03,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPsoriatic arthritis (PsA) patient data from two phase 3 secukinumab trials (FUTURE 1, 5) were analysed to quantify the prevalence and extent of pre-existing radiographic damage (RD) at baseline; investigate the association of RD with swollen/tender joint counts (SJC/TJC) at baseline; and investigate the extent to which RD at baseline correlated with response to secukinumab.MethodsPooled data (N = 1554) provided baseline radiographic bone erosion and joint space narrowing (JSN) scores at pre-specified locations per the van der Heijde-modified total Sharp score (vdH-mTSS) for PsA and swollen and tender joint scores in the same joints at multiple visits. Overall patient RD and individual joints RD bone erosion and JSN scores were assessed. The association between joint activity (tenderness, swelling) and vdH-mTSS was assessed at the overall patient-level and individual joint tender, swollen scores (yes/no) and RD joint JSN and bone erosion scores at the individual joint-level. Treatment response was assessed using SJC/TJC at weeks 16 and 52 and the proportion of patients achieving minimal disease activity (MDA) over all assessments within 1 year from FUTURE 5 alone.ResultsA substantial prevalence of pre-existing RD with higher prevalence of erosion than JSN was observed (86% and 60% of patients had positive erosion and JSN scores, respectively); higher RD prevalence was associated with longer time since PsA diagnosis. Joint activity was weakly associated with RD at baseline at the patient-level (Pearson’s coefficients: range 0.12–0.18), but strongly associated at the individual joint-level, with a higher probability of tender/swollen joints to associate with higher JSN/erosion scores: all 42 analysed joints showed statistical significance at the 0.05 level (unadjusted) for the relationship between joint tenderness (yes/no) and its JSN score, all but one for tenderness and bone erosion scores, and all but 2 for swollen and JSN scores and for swollen and bone erosion score. Secukinumab (150/300 mg), reduced TJC and SJC across all values of baseline erosion and JSN scores at weeks 16 and 52. Patients with higher levels of RD were less likely to achieve zero tender/zero swollen joint status and had lower chance of achieving MDA.ConclusionsPsA patients showed substantial prevalence of RD at baseline that correlated with time since diagnosis, but patient’s individual joint activity was strongly associated with pre-existing RD at those joints. Patients with the highest RD at baseline had a reduced likelihood of achieving zero joint count status.

【 授权许可】

CC BY   
© The Author(s) 2022

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