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07-11-2020 | Rheumatology | News | Article

ACR 2020

Secukinumab may reduce the burden of Achilles tendon enthesitis in patients with spondyloarthritis

Author: Claire Barnard

medwireNews: The interleukin (IL)-17A inhibitor secukinumab may improve pain and disease activity among patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) and imaging-confirmed enthesitis at the Achilles tendon, suggest findings from the ACHILLES trial.

However, secukinumab was not significantly better than placebo for the primary endpoint of Achilles tendon enthesitis resolution at week 24, reported Frank Behrens (Goethe University, Frankfurt, Germany) in a poster presentation at the ACR Convergence 2020 virtual meeting.

The phase 3b study included 204 patients with active PsA or axSpA and a clinical diagnosis of Achilles tendon enthesitis despite treatment with nonsteroidal anti-inflammatory drugs at the maximum recommended dose. Participants were randomly assigned to receive subcutaneous secukinumab 150 mg or 300 mg every 4 weeks following a once-weekly loading dose at weeks 0–4, or to receive placebo.

At the 24-week follow-up, the proportion of patients with clinical resolution of Achilles tendon enthesitis was numerically higher in the secukinumab than the placebo arm, at 42.2% versus 31.4%, but the between-group difference did not reach statistical significance.

Nevertheless, Behrens and colleagues found that heel pain at week 24, as measured on an 11-point numeric rating scale, was “notably reduced” among participants treated with the IL-17A inhibitor versus placebo, with corresponding mean reductions from baseline of 2.7 compared with 1.9 points.

Average physician- and patient- reported heel enthesopathy visual analog scale scores also improved to a significantly greater degree in the secukinumab compared with the placebo arm, as did mean physician and patient global assessment of disease activity scores and quality of life (QoL), as assessed by SF-36 version 2 surveys.

Behrens reported that participants in the placebo arm switched to secukinumab at week 24, and after this timepoint participants from both groups experienced “continuous improvement” in resolution of Achilles tendon enthesitis, as well as sustained improvements in heel pain, disease activity, and QoL.

Overall, despite failing to meet its primary endpoint, “this very unique study” demonstrated “a lot of response to secukinumab in this important feature in SpA,” the presenter concluded.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group

ACR Convergence virtual meeting; 5–9 November 2020

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