ABSTRACT
INTRODUCTION: Secukinumab (Cosentyx) is an interleukin-17A (IL-17A) inhibitor administered subcutaneously. Through 2016, it had received approval in a number of countries, including the USA, Japan and in the EU for the treatment of plaque psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS). AREAS COVERED: This review addresses the mechanism of action, efficacy and safety of secukinumab observed in clinical studies of patients with PsA. Data from recent studies of secukinumab in psoriasis, PsA and AS are included. Expert commentary: Secukinumab appears to be effective in improving various aspects of PsA, including improvements in psoriatic skin, enthesitis and dactylitis, as well as inhibition of the radiographic progression of peripheral arthritis. Secukinumab was in general well tolerated; the most common adverse events were nasopharyngitis, headache, and upper respiratory tract infection.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Arthritis, Psoriatic/drug therapy , Immunotherapy/methods , Skin/drug effects , Spondylitis, Ankylosing/drug therapy , Animals , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Clinical Trials as Topic , Europe , Headache/etiology , Humans , Interleukin-17/immunology , Japan , Nasopharyngitis/etiology , Respiratory Tract Infections/etiology , Skin/pathology , United StatesABSTRACT
OBJECTIVE: Infections and thromboses are known complications of systemic lupus erythematosus (SLE). We investigated if infectious episodes in patients with SLE were followed by an increased risk of thrombotic events. METHODS: A cohort of 571 patients with prevalent or incident SLE was followed for a mean of 8.9 ± 7.6 years. All episodes of hospitalized infections or episodes of cutaneous herpes zoster as well as arterial and venous thrombotic events were identified by retrospective chart review and prospective updating of a clinical database. For time-dependent analyses adjusted for age, sex, and ever-presence of antiphospholipid antibodies, thrombotic events were classified as occurring during the time at risk of 1 year after an infection or during the remaining control observation time. RESULTS: Of 271 infections identified, 104 were respiratory, 41 cutaneous herpes zoster, and 126 others. Of 159 thromboses identified, 98 were arterial. Incidence for arterial and venous thromboses within 1 year after infection was 2.18% and 2.56%, respectively, compared to patients who never had an infection (0.58 and 0.67). The adjusted 1-year risk of arterial and venous thrombosis after any infection was increased [relative rate (RR) 2.5, 95% CI 1.4-4.6, and RR 2.8, 95% CI 1.3-5.9, respectively]. Venous thromboses were in particular more prevalent after respiratory infections (RR 5.4, 95% CI 2.3-13). CONCLUSION: The temporal associations observed in this study indicate that infections could be risk factors for arterial or venous thromboses in patients with SLE, although causality was not addressed by this study.