Artikel
Secukinumab for the treatment of psoriatic arthritis: comparative effectiveness results versus licensed biologics and apremilast from a network meta-analysis
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Autoren
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Hendrik Schulze-Koops
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Rheumatologie, München
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Iain McInnes
- University of Glasgow, Glasgow, England
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Eirini Palaka
- Novartis Ireland Ltd, Dublin, Ireland
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Kunal Gandhi
- Novartis Pharmaceuticals Corporation, East Hanover, USA
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Shephard Mpofu
- Novartis Pharma AG, Basel, Switzerland
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Steffen Jugl
- Novartis Pharma AG, Basel, Schweiz
| Veröffentlicht: | 29. August 2016 |
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Gliederung
Text
Background: The FUTURE 1 and 2 RCTs demonstrated superiority of Secukinumab over placebo. As no direct trial comparisons are yet available there is a need for comparative effectiveness assessment.
Objective: Comparative assessment of Secukinumab via NMA vs. licensed biologics and apremilast in adults with active PsA who had failed conventional DMARD therapy.
Methods: A systematic review identified 20 relevant RCTs. NMAs were conducted following HTA-guidance using Bayesian fixed-effects models. The results of pairwise comparisons are presented for Secukinumab using RRs [95%CrI]. Non-responder imputation data were used for all comparators except golimumab QM and infliximab 5 mg/kg Q2M for which only last observation carried forward data were available. Analyses were performed in biologic-naïve, biologic-experienced, and mixed populations at week 16 for ACR and at weeks 12–16 for PASI.
Results: In the biologic-naïve population, ACR20 responses were statistically significantly higher for Secukinumab 150 mg (61%) and 300 mg (58%) than for ustekinumab QM 45 mg (RR 1.95 [1.29–2.86] and 1.84 [1.21–2.74], respectively), and for Secukinumab 150 mg vs ustekinumab 90 mg (RR 1.52 [1.03–2.16]). ACR20, 50 and 70 responses were statistically significantly higher for Secukinumab vs. apremilast BID 20 mg (RR 2.51 [1.52–4.29] and 2.37 [1.39–4.12] respectively), and for Secukinumab 150 mg vs. apremilast 30 mg (RR 1.72 [1.09–2.71]). Sensitivity analyses using the mixed population were in general agreement with these observations. For PASI50, 75, and 90 in the biologic-naïve population, only a small evidence network with Secukinumab, golimumab 50/100mg, adalimumab 40 mg and infliximab was available and there were no statistically significant differences between them. In the mixed population, Secukinumab was statistically significantly superior to adalimumab, apremilast 20/30 mg, certolizumab pegol 200/400 mg, etanercept 25/50 mg BIW and 50 mg QW, and (Secukinumab 300 mg only) golimumab 50 mg.
Figure 1 [Fig. 1]
Conclusion: Secukinumab shows statistically significantly higher results vs. ustekinumab and apremilast in ACR20, 50 and 70, with at least comparable response rates across all ACR and PASI endpoints. For PASI50, 75, and 90 responses, Secukinumab hadstatistically significant higher results vs. adalimumab, apremilast, certolizumab pegol, etanercept, and (Secukinumab 300 mg only) golimumab 50 mg.
