P253 Secukinumab provides sustained improvements in tender and swollen joint counts: 5year results from the Phase 3 FUTURE 2 study

Abstract

Background: Secukinumab, a fully human monoclonal antibody that neutralises interleukin-17A, demonstrated long-term efficacy and tolerability in psoriatic arthritis (PsA) patients in FUTURE 2. Tender joint count (TJC) and swollen joint count (SJC) scores are components of composite measures used to assess treatment response, which can include confounding factors. TJC and SJC were developed for rheumatoid arthritis, assessing 68 and 66 joints, respectively. Later, these scores evolved for use in PsA, which can affect small joints of the feet, assessing 78 and 76 joints. TJC and SJC measure synovitis, a key assessment of disease activity. Herein, we report the 5-year efficacy of secukinumab on reduction of 78 TJC and 76 SJC in FUTURE 2. Methods: 397 patients with active PsA were randomised to subcutaneous secukinumab loading dose (300, 150, 75 mg) or placebo at baseline, Weeks 1, 2, 3 and 4, and every 4 weeks thereafter. Placebo-treated patients were re-randomised to secukinumab 300 or 150mg at Week 16 (non-responders) or 24 (responders). Secukinumab dose was escalated from 150 to 300 mg, and 75 to 150 or 300mg starting at Week 128 and maintained thereafter, if active signs of disease were observed based on physician's assessment. Data are reported as observed for secukinumab 300 and 150mg (approved PsA doses) over 5 years (2 years of core study and 3-year extension). Results: Baseline characteristics were comparable across treatment arms (Table 1). Overall, 62.5% (248/397) of all patients randomised completed 260 weeks of treatment. Of these, 48/65 (73.8%) and 49/66 (74.2%) patients randomised to secukinumab 300 and 150mg achieved ACR20 at Week 260, respectively. Improvements in adjusted 78 TJC and 76 SJC change from baseline were sustained from Week 16 to Week 260 in all treatment groups (Table 1). At Week 260, mean change from baseline in adjusted 78 TJC/76 SJC was -12.8/-9.3 and -15.1/-8.5 for the secukinumab 300mg and 150mg group (including patients up-titrated to 300 mg), respectively. Numerical differences were comparable between secukinumab doses. Conclusion: Secukinumab 300 and 150mg provided sustained improvements in 78 TJC and 76 SJC scores over 5 years; numerical differences were comparable between secukinumab doses.