Clinical Experience with Sekukinumab and Evaluation of Inflammatory Parameters in Psöriatic Arthritis
Öz
Objective: Secukinumab is a human immunoglobulin G1 kappa monoclonal antibody that binds to Interleukin-17A. The objective of this study was to evaluate the dermographic, clinical and inflammatory parameters, treatment duration and side effect profile of patients with psoriatic arthritis who were treated with secukinumab.
Material-method: Patients diagnosed with PsA according to 2006 CASPAR classification criteria and receiving secukinumab treatment were included in the study. The efficacy and safety of the treatment were evaluated. Drug survival was analyzed.The pre- and post-treatment monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII) (platelet count x neutrophil count / lymphocyte count), and systemic inflammatory response index (SIRI) (neutrophil count x monocyte count / lymphocyte count) were calculated as inflammatory parameters.
Results: Of the 41 patients with PsA who were included in the study, 29 (70.7%) continued with secukinumab treatment for 45 months. Twelve patients (29.3%) discontinued treatment. The most common reason for discontinuation was drug ineffectiveness, and dyspeptic complaints and gastrointestinal side effects were found to be side effects. No statistically significant difference was identified in the inflammatory parameters analysed before and after treatment.
Conclusion: In the present study, despite the fact that the majority of patients had previously undergone treatment with a biological agent, the survival rates observed in those receiving secukinumab were found to be relatively high. Secukinumab is currently being employed in clinical practice as an efficacious treatment option for the management of PsA.
Anahtar Kelimeler
Kaynakça
- 1. Ogdie, A. Coates, LC. Gladman, DD. Treatment guidelines in psoriatic arthritis. 2020. Rheumatology;59: i37–46.
- 2. Hackett, S. Coates, L. 2020. Psoriatic arthritis: An up to date overview. Indian J Rheumato l; 15:45.
- 3. Azuaga, AB. Ramírez, J. Cañete, JD. 2023. Psoriatic Arthritis: Pathogenesis and Targeted Therapies. Int J Mol Sci; 24:4901.
- 4. Toussi, A. Maverakis, N. Le, ST. Sarkar, S. Raychaudhuri, SK. Raychaudhuri, SP. 2020. Updated therapies for the management of Psoriatic Arthritis. Clinical Immunology; 220:108536.
- 5. Blair, HA. 2021. Secukinumab: A Review in Psoriatic Arthritis. Drugs; 81:483–94.
- 6. Nash, P. Mease, PJ. McInnes, IB. Rahman, P. Ritchlin, CT. Blanco, R. et al. 2018. Efficacy and safety of secukinumab administration by autoinjector in patients with psoriatic arthritis: results from a randomized, placebo-controlled trial (FUTURE 3). Arthritis Res Ther; 20:47.
- 7. Mease, PJ. Kavanaugh, A. Reimold, A. Tahir, H. Rech, J. Hall, S. et al. 2020. Secukinumab Provides Sustained Improvements in the Signs and Symptoms of Psoriatic Arthritis: Final 5-year Results from the Phase 3 FUTURE 1 Study. ACR Open Rheumatol; 2:18–25.
- 8. Mease, P. van der Heijde, D. Landewé, R. Mpofu, S. Rahman, P. Tahir, H. et al. 2018. Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study. Ann Rheum Dis;77: 890–7.
- 9. McInnes, IB. Behrens, F. Mease, PJ. Kavanaugh, A. Ritchlin, C. Nash, P. et al. 2020. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet;395: 1496–505.
- 10. Asahina, A. Kubo, N. Umezawa, Y. Honda, H. Yanaba, K. Nakagawa, H. 2017. Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol;44: 1112–21.
- 11. Ma, R. Cui, L. Cai, J. Yang, N. Wang, Y. Chen, Q. et al. 2024. Association between systemic immune inflammation index, systemic inflammation response index and adult psoriasis: evidence from NHANES. Front Immunol;15.
- 12. Eviatar, T. Zisman, D. Gendelman, O. Reitblat, T. Balbir-Gurman, A. Mashiach, T. et al. 2022. Secukinumab real world drug retention compared to TNF-alpha inhibitors in psoriatic arthritis. Clin Exp Rheumatol;40: 15–23.
- 13. Michelsen, B. Lindström, U. Codreanu, C. Ciurea, A. Zavada, J. Loft, AG et al. 2020. Drug retention, inactive disease and response rates in 1860 patients with axial spondyloarthritis initiating secukinumab treatment: routine care data from 13 registries in the EuroSpA collaboration. RMD Open;6.
- 14. Michelsen, B. Georgiadis, S. Di Giuseppe, D. Loft, AG. Nissen, MJ. Lannone, F. et al. 2022 Real-World Six- and Twelve-Month Drug Retention, Remission, and Response Rates of Secukinumab in 2,017 Patients With Psoriatic Arthritis in Thirteen European Countries. Arthritis Care Res (Hoboken);74: 1205–18.
- 15. Alonso, S. Villa, I. Fernández, S. Martín, JL. Charca, L. Pino, M. et al. 2021. Multicenter Study of Secukinumab Survival and Safety in Spondyloarthritis and Psoriatic Arthritis: SEcukinumab in Cantabria and ASTURias Study. Front Med (Lausanne); 8 :679009.
- 16. Alenius, GM. 2006. Antibodies against cyclic citrullinated peptide (CCP) in psoriatic patients with or without joint inflammation. Ann Rheum Dis; 65:398–400.
- 17. Vander Cruyssen, B. Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. 2005. Ann Rheum Dis;64:1145–9.
- 18. Schreiber, S, Colombel, J-F. Feagan, BG. Reich, K. Deodhar, AA. McInnes, IB. et al. 2019. Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials. Ann Rheum Dis; 78:473–9.
- 19. Elewski, BE. Baddley, JW. Deodhar, AA. Magrey, M. Rich, PA. Soriano, ER. et al. 2021. Association of Secukinumab Treatment With Tuberculosis Reactivation in Patients With Psoriasis, Psoriatic Arthritis, or Ankylosing Spondylitis. JAMA Dermatol; 157:43.
- 20. Hua, Y. Sun, J-Y. Lou, Y-X. Sun, W. Kong, X-Q. 2023. Monocyte-to-lymphocyte ratio predicts mortality and cardiovascular mortality in the general population. Int J Cardiol;379: 118–26.
- 21. Liu, B. Wang, J. Li, Y-Y. Li, K-P. Zhang, Q. 2023. The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999-2018. Arthritis Res Ther; 25:34.
- 22. Gasparyan, AY. Ayvazyan, L. Mukanova, U. Yessirkepov, M. Kitas, GD. 2019. The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Ann Lab Med;39: 345–57.
- 23. Zahorec, R. 2021. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratislava Medical Journal ;122:474–88..
- 24. Beygi, S. Lajevardi, V. Abedini, R. 2014. C-reactive protein in psoriasis: a review of the literature. J Eur Acad Dermatol Venereol 2014; 28: 700–11.
- 25. Dhir, V. Aggarwal, A. 2013. Psoriatic arthritis: a critical review. Clin Rev Allergy Immunol;44:141–8.
- 26. KarataŞ, A. Gerçek, AN. Öz, B. Gözel, N. Pişkin, Sağır R. Gür, M. et al. 2020. The effect of secukinumab treatment on hematological parameters in ankylosing spondylitis and psoriatic arthritis. Eur J Rheumatol ;7:169–72.
- 27. Yorulmaz, E. Geler Külcü, D. 2023. The effect of IL-17 blockage on the neutrophil to lymphocyte ratio in patients with axial spondylarthritis: a comparative study with anti-TNF. The European Research Journal ;9 :8–13.
- 28. Tamer, F. Avcı, E. 2020. Serum C-reactive protein to albumin ratio as a novel inflammation biomarker in psoriasis patients treated with adalimumab, ustekinumab, infliximab, and secukinumab: a retrospective study. Croat Med J; 61: 333–7.
- 29. Bektaş, M. Çetin, Ç. Uğurlu, ÇB. Kemik, F. Çiftçi, AC. Yalçınkaya, Y. et al. 2021. Real life data of secukinumab in ankylosing spondylitis and psoriatic arthritis: Analysis of 44 patients in a single center. Ulusal Romatoloji Dergisi; 13:116–20.
- 30. Merola, JF. McInnes, IB. Deodhar, AA. Dey, AK. Adamstein, NH. Quebe-Fehling, E. et al. 2022. Effect of Secukinumab on Traditional Cardiovascular Risk Factors and Inflammatory Biomarkers: Post Hoc Analyses of Pooled Data Across Three Indications. Rheumatol Ther 2022; 9: 935–55.
Öz
Amaç: Sekukinumab İnterlökin-17A’ ya bağlanan insan immünoglobulin G1 kappa monoklonal antikorudur. Bu çalışmada sekukinumab tedavisi kullanan psöriyatik artrit (PsA) hastalarının dermografik, klinik ve inflamatuvar paremetrelerini, tedaviye devam sürelerini ve yan etki profilini değerlendirmeyi amaçladık.
Materyal-Metot: Çalışmaya 2006 CASPAR sınıflandırma kriterlerine göre PsA tanısı almış ve sekukinumab tedavisi kullanan hastalar dahil edildi. Tedavinin etkinliği ve güvenliği değerlendirildi. İlaç sağkalımı analiz edildi. Tedavi öncesi ve sonrası monosit/lenfosit oranı (MLO), nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO), sistemik immün inflamasyon indeksi(SII) (trombosit sayısı x nötrofil sayısı/ lenfosit sayısı), sistemik inflamatuvar cevap indeksi (SIRI) (nötrofil sayısı x monosit sayısı / lenfosit sayısı) inflamatuvar paremetreleri hesaplandı.
Bulgular: Çalışmaya dahil edilen 41 PsA hastasının 45 ay süresince 29 (%70,7)’ unun sekukinumab tedavisine devam ettiği görüldü. Hastaların 12 (%29,3) tedaviyi bıraktı. Tedaviyi en sık bırakma nedeninin ilaç etkisizliği olduğu, yan etki olarak da dispeptik yakınmalar ve gastrointestinal yan etkiler olduğu tespit edildi. Tedavi öncesi ve sonrasında bakılan inflamatuvar paremetrelerde istatiksel olarak anlamlı bir farklılık saptanmadı.
Sonuç: Çalışmamızda hastaların büyük bir kısmında daha önce bir biyolojik ajan kullanmış olmasına rağmen sekukinumab tedavisinde kalım oranlarının oldukça yüksek olduğu saptanmıştır. Sekukinumab, PsA tedavisinde etkili bir tedavi seçeneği olarak klinik kullanımımızda yer almaktadır.
Anahtar Kelimeler
Etik Beyan
Bu çalışma Süleyman Demirel Üniversitesi Etik Kurulu tarafından 17.09.2024 tarihinde E-87432956-050.99-838809 sayı numarası ile onay almıştır.
Kaynakça
- 1. Ogdie, A. Coates, LC. Gladman, DD. Treatment guidelines in psoriatic arthritis. 2020. Rheumatology;59: i37–46.
- 2. Hackett, S. Coates, L. 2020. Psoriatic arthritis: An up to date overview. Indian J Rheumato l; 15:45.
- 3. Azuaga, AB. Ramírez, J. Cañete, JD. 2023. Psoriatic Arthritis: Pathogenesis and Targeted Therapies. Int J Mol Sci; 24:4901.
- 4. Toussi, A. Maverakis, N. Le, ST. Sarkar, S. Raychaudhuri, SK. Raychaudhuri, SP. 2020. Updated therapies for the management of Psoriatic Arthritis. Clinical Immunology; 220:108536.
- 5. Blair, HA. 2021. Secukinumab: A Review in Psoriatic Arthritis. Drugs; 81:483–94.
- 6. Nash, P. Mease, PJ. McInnes, IB. Rahman, P. Ritchlin, CT. Blanco, R. et al. 2018. Efficacy and safety of secukinumab administration by autoinjector in patients with psoriatic arthritis: results from a randomized, placebo-controlled trial (FUTURE 3). Arthritis Res Ther; 20:47.
- 7. Mease, PJ. Kavanaugh, A. Reimold, A. Tahir, H. Rech, J. Hall, S. et al. 2020. Secukinumab Provides Sustained Improvements in the Signs and Symptoms of Psoriatic Arthritis: Final 5-year Results from the Phase 3 FUTURE 1 Study. ACR Open Rheumatol; 2:18–25.
- 8. Mease, P. van der Heijde, D. Landewé, R. Mpofu, S. Rahman, P. Tahir, H. et al. 2018. Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study. Ann Rheum Dis;77: 890–7.
- 9. McInnes, IB. Behrens, F. Mease, PJ. Kavanaugh, A. Ritchlin, C. Nash, P. et al. 2020. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet;395: 1496–505.
- 10. Asahina, A. Kubo, N. Umezawa, Y. Honda, H. Yanaba, K. Nakagawa, H. 2017. Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol;44: 1112–21.
- 11. Ma, R. Cui, L. Cai, J. Yang, N. Wang, Y. Chen, Q. et al. 2024. Association between systemic immune inflammation index, systemic inflammation response index and adult psoriasis: evidence from NHANES. Front Immunol;15.
- 12. Eviatar, T. Zisman, D. Gendelman, O. Reitblat, T. Balbir-Gurman, A. Mashiach, T. et al. 2022. Secukinumab real world drug retention compared to TNF-alpha inhibitors in psoriatic arthritis. Clin Exp Rheumatol;40: 15–23.
- 13. Michelsen, B. Lindström, U. Codreanu, C. Ciurea, A. Zavada, J. Loft, AG et al. 2020. Drug retention, inactive disease and response rates in 1860 patients with axial spondyloarthritis initiating secukinumab treatment: routine care data from 13 registries in the EuroSpA collaboration. RMD Open;6.
- 14. Michelsen, B. Georgiadis, S. Di Giuseppe, D. Loft, AG. Nissen, MJ. Lannone, F. et al. 2022 Real-World Six- and Twelve-Month Drug Retention, Remission, and Response Rates of Secukinumab in 2,017 Patients With Psoriatic Arthritis in Thirteen European Countries. Arthritis Care Res (Hoboken);74: 1205–18.
- 15. Alonso, S. Villa, I. Fernández, S. Martín, JL. Charca, L. Pino, M. et al. 2021. Multicenter Study of Secukinumab Survival and Safety in Spondyloarthritis and Psoriatic Arthritis: SEcukinumab in Cantabria and ASTURias Study. Front Med (Lausanne); 8 :679009.
- 16. Alenius, GM. 2006. Antibodies against cyclic citrullinated peptide (CCP) in psoriatic patients with or without joint inflammation. Ann Rheum Dis; 65:398–400.
- 17. Vander Cruyssen, B. Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. 2005. Ann Rheum Dis;64:1145–9.
- 18. Schreiber, S, Colombel, J-F. Feagan, BG. Reich, K. Deodhar, AA. McInnes, IB. et al. 2019. Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: a retrospective analysis of pooled data from 21 clinical trials. Ann Rheum Dis; 78:473–9.
- 19. Elewski, BE. Baddley, JW. Deodhar, AA. Magrey, M. Rich, PA. Soriano, ER. et al. 2021. Association of Secukinumab Treatment With Tuberculosis Reactivation in Patients With Psoriasis, Psoriatic Arthritis, or Ankylosing Spondylitis. JAMA Dermatol; 157:43.
- 20. Hua, Y. Sun, J-Y. Lou, Y-X. Sun, W. Kong, X-Q. 2023. Monocyte-to-lymphocyte ratio predicts mortality and cardiovascular mortality in the general population. Int J Cardiol;379: 118–26.
- 21. Liu, B. Wang, J. Li, Y-Y. Li, K-P. Zhang, Q. 2023. The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999-2018. Arthritis Res Ther; 25:34.
- 22. Gasparyan, AY. Ayvazyan, L. Mukanova, U. Yessirkepov, M. Kitas, GD. 2019. The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Ann Lab Med;39: 345–57.
- 23. Zahorec, R. 2021. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratislava Medical Journal ;122:474–88..
- 24. Beygi, S. Lajevardi, V. Abedini, R. 2014. C-reactive protein in psoriasis: a review of the literature. J Eur Acad Dermatol Venereol 2014; 28: 700–11.
- 25. Dhir, V. Aggarwal, A. 2013. Psoriatic arthritis: a critical review. Clin Rev Allergy Immunol;44:141–8.
- 26. KarataŞ, A. Gerçek, AN. Öz, B. Gözel, N. Pişkin, Sağır R. Gür, M. et al. 2020. The effect of secukinumab treatment on hematological parameters in ankylosing spondylitis and psoriatic arthritis. Eur J Rheumatol ;7:169–72.
- 27. Yorulmaz, E. Geler Külcü, D. 2023. The effect of IL-17 blockage on the neutrophil to lymphocyte ratio in patients with axial spondylarthritis: a comparative study with anti-TNF. The European Research Journal ;9 :8–13.
- 28. Tamer, F. Avcı, E. 2020. Serum C-reactive protein to albumin ratio as a novel inflammation biomarker in psoriasis patients treated with adalimumab, ustekinumab, infliximab, and secukinumab: a retrospective study. Croat Med J; 61: 333–7.
- 29. Bektaş, M. Çetin, Ç. Uğurlu, ÇB. Kemik, F. Çiftçi, AC. Yalçınkaya, Y. et al. 2021. Real life data of secukinumab in ankylosing spondylitis and psoriatic arthritis: Analysis of 44 patients in a single center. Ulusal Romatoloji Dergisi; 13:116–20.
- 30. Merola, JF. McInnes, IB. Deodhar, AA. Dey, AK. Adamstein, NH. Quebe-Fehling, E. et al. 2022. Effect of Secukinumab on Traditional Cardiovascular Risk Factors and Inflammatory Biomarkers: Post Hoc Analyses of Pooled Data Across Three Indications. Rheumatol Ther 2022; 9: 935–55.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Romatoloji ve Artrit |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Nisan 2025 |
| Gönderilme Tarihi | 23 Eylül 2024 |
| Kabul Tarihi | 30 Ocak 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 16 Sayı: 1 |
