Biological therapies secukinumab and adalimumab are similarly effective at improving the musculoskeletal symptoms of psoriatic arthritis despite differing mechanisms of action, a head-to-head trial funded by Novartis and published in The Lancet suggests (9 May 2020)
The multicentre, double-blind, active-controlled study enrolled 853 patients with psoriatic arthritis who were randomly assigned to receive 300mg of the IL-17A inhibitor, secukinumab, or 40mg of the anti-TNF agent, adalimumab, for 52 weeks. Treatment response was measured by the American College of Rheumatology (ACR) response criteria.
At week 52, the researchers found that a similar proportion of patients had at least a 20% improvement in the ACR response criteria in each group at 67% for secukinumab and 62% for adalimumab. The safety profiles were in accordance with previous data, although secukinumab was associated with a higher treatment retention rate.
Most patients with psoriatic arthritis are treated first-line with conventional disease-modifying therapy like methotrexate. But the researchers said there is a lack of data to inform the choice of biological therapy where methotrexate is ineffective or intolerable.
“This study presents a considerable volume of comparative efficacy and safety data on two biological agents with different mechanisms of action in the treatment of patients with psoriatic arthritis,” they concluded.
 McInnes I, Behrens F, Mease P et al. Lancet 2020;395:1496–1505. doi: 10.1016/S0140-6736(20)30564-X