Abstract
Psoriatic arthritis (PsA) is characterized by a number of skeletal and extra-skeletal manifestations, which include skin and nail involvement, acute anterior uveitis, and idiopathic intestinal inflammation. These are heterogeneous diseases that vary in the severity of their manifestations.
The author assesses the efficacy of secukinumab across different domains of PsA, such as arthritis, radiographic progression, the effect on enthesitis, dactylitis, axial involvement, and nail psoriasis. The article presents data from randomized controlled trials and complements them with results from the ATTRA National Registry of Biologic Therapies.
At our institution, we have monitored the long-term efficacy in a total of 426 patients with PsA. Survival on treatment at three years was 64.6%.
After two years of treatment, there was a significant decrease in the Disease Activity Score in 28 joints calculated using C-reactive protein (DAS28-CRP-FW) for rheumatoid arthritis, with 54% of patients meeting remission criteria (DAS28-CRP-FW < 2.6) and 74.8% meeting criteria for low disease activity status (DAS28-CRP-FW < 3.2). Data on the presence of heel enthesitis in 417 patients were available in the ATTRA registry.
Heel enthesitis was present in 12.2% of patents at the start of treatment and then in 1.5% of patients after 24 months of treatment. Dactylitisoccurred in 22% of patients in the ATTRA registry at the start of treatment and decreased to 4.7% after two years of treatment.
Moderate and severe nail involvement was reported in 33.2% of patients in the ATTRA registry at the start of treatment, and this decreased to 3.8% of patients after two years of treatment.