gms | German Medical Science

45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

Improvement of joint inflammation as assessed by MRI and power doppler ultrasound in an open label study in patients with active psoriatic arthritis treated with secukinumab (PSARTROS)

Meeting Abstract

  • Eleni Kampylafka - Innere Medizin 3 – Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen; Universitätsklinikum Erlangen, Erlangen
  • Isabelle dÒliveira - Universität Erlangen-Nürnberg Medizinische Klinik 3, Rheumatologie & Immunologie, Erlangen
  • Christina Linz - Innere Medizin 3 – Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen; Universitätsklinikum Erlangen, Erlangen
  • Veronika Lerchen - Innere Medizin 3 – Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen; Universitätsklinikum Erlangen, Erlangen
  • Matthias Englbrecht - Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
  • Arnd Kleyer - Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
  • Jürgen Rech - Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
  • Georg Schett - Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
  • Axel Hueber - Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.01

doi: 10.3205/17dgrh045, urn:nbn:de:0183-17dgrh0459

Published: September 4, 2017

© 2017 Kampylafka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Secukinumab, an anti-interleukin 17A monoclonal antibody, showed significant improvement of signs and symptoms of psoriatic arthritis (PsA) in FUTURE 1 study. Available studies used conventional radiography, not allowing a deeper imaging analysis of the inflammatory changes.

The aim of the study was to assess short term efficacy of secukinumab on inflammation and structural damage according to change in OMERACT-EULAR ultrasound score and MRI PsAMRIS score in PsA patients.

Methods: PsA patients with active disease (TJC and SJC ≥ 3), were included in the 24 week open label prospective PSARTROS study and treated with subcutaneous secukinumab 300 mg. Baseline 1,5T MRI hand scans and ultrasound imaging of 28 joints were performed at baseline and after 24 weeks of treatment. MRI was scored according to PsAMRIS, ultrasound for synovial hypertrophy and Doppler activity according to OMERACT scores. Statistical significance was set at p≤0.05.

Results: 20 patients, mean age 52 ± 9.9 years, 60% female, mean disease duration 6.7 ± 5.9 years, 50% naïve for biological therapy, were included. Three patients were early discontinued (recurrent pharyngitis, lack of efficacy, withdrawal of consent). Baseline DAS28 was 5.03±0.96, baseline DAPSA was 32.2±12.1. On baseline MRI, all patients had at least one inflammatory sign (synovitis: 90%, osteitis: 20%, periarticular inflammation: 25%, flexor tenosynovitis: 35%, bone proliferation: 30%, erosions: 60%). Baseline composite PsAMRIS score was 11.6±12.8 and baseline PsAMRIS synovitis score was 3.7±3.3. Baseline ultrasound synovial hypertrophy and Doppler activity were 6.2±4.5 and 3.5±4.0, respectively. Clinical disease activity parameters significantly improved at follow up (DAS28: 2.94±0.95, p<0.001; DAPSA: 8.8±5.8, p<0.001). PsAMRIS synovitis score (2.5±2.4) and composite PsAMRIS score (8.8±10.0) decreased longitudinally with secukinumab treatment (p=0.034 and p=0.039, respectively). There was no progression in erosion or proliferation scores between baseline and follow-up. Synovial hypertrophy and Doppler activity in ultrasound also significantly improved with secukinumab treatment (2.3±3.5; p=0.009 and 1.8±2.7; p=0.003, respectively). A significant percentage of patients reaching minimal disease activity showed residual signs of synovitis in MRI and US (66% and 50%, respectively).

Conclusion: Secukinumab significantly improves MRI and ultrasound signs of joint inflammation in patients with PsA.

This study was supported by an unrestricted grant from Novartis.