Celletti Eleonora, Gualdi Giulio, Sabatini Emanuela, Cipollone Francesco, Lobefaro Fabio, Amerio Paolo
Rheumatology Service, Medical Clinic, ASL 2 Abruzzo, G. d'Annunzio University, Chieti.
Unit of Dermatology, Department of Medicine and Aging Science, G. d'Annunzio University, Chieti.
Reumatismo. 2025 Jun 10;77(2). doi: 10.4081/reumatismo.2025.1694. Epub 2025 Jan 27.
Psoriatic arthritis (PsA) can be treated with biological drugs targeting IL-17A, such as secukinumab, with good responses and long-term positive outcomes in clinical studies.
An observational study was conducted on adult subjects with PsA and comorbidities treated with secukinumab after prior therapy with conventional disease-modifying anti-rheumatic drugs or biological agents that were discontinued due to lack of efficacy or adverse drug reactions. Patients were followed up with clinical visits at 3, 6, 9, and 12 months and evaluated for disease activity, pain, and quality of life compared to baseline. Moreover, a narrative review of the literature was performed on secukinumab's use for PsA in real life.
Fifteen patients completed 6 months of follow-up, eleven patients completed 9 months, and six patients were followed for 12 months. The major comorbidities recorded were fibromyalgia (33% of patients), recurrent bilateral anterior uveitis, and autoimmune thyroiditis with hypothyroidism (both 13% of the patients). A significant improvement in Disease Activity Score-28 was recorded at 6 and 9 months, while a significant difference vs. baseline was seen at 3, 6, and 9 months for the Psoriasis Area Severity Index. The Bath Ankylosing Spondylitis Disease Activity Index showed significant differences vs. baseline at 9 and 12 months. There was an improving trend at 9 and 12 months for pain scores and a significant improvement at 6 and 9 months for the physical component and at 12 months for the social component (Short Form 36 Health Survey quality of life scores). For the review of the literature, 35 articles were identified, but only 17 papers were eventually considered.
Secukinumab has demonstrated effectiveness for PsA treatment in several real-world studies. Both patient-oriented and clinician-oriented outcomes showed a significant improvement with this treatment. The present real-world evaluation adds further evidence on the use of secukinumab for PsA treatment, showing the rapid, safe, clinically significant, and sustained responses of PsA patients affected by co-morbidities.
银屑病关节炎（PsA）可用靶向IL-17A的生物药物治疗，如司库奇尤单抗，在临床研究中疗效良好且长期预后积极。
对成年PsA患者及合并症患者进行一项观察性研究，这些患者在先前使用传统改善病情抗风湿药物或生物制剂治疗后，因疗效不佳或药物不良反应而停药，随后接受司库奇尤单抗治疗。在3、6、9和12个月时对患者进行临床随访，并与基线相比评估疾病活动度、疼痛和生活质量。此外，对司库奇尤单抗在现实生活中治疗PsA的情况进行了文献叙述性综述。
15例患者完成了6个月的随访，11例患者完成了9个月的随访，6例患者随访了12个月。记录的主要合并症有纤维肌痛（占患者的33%）、复发性双侧前葡萄膜炎以及自身免疫性甲状腺炎伴甲状腺功能减退（均占患者的13%）。在6个月和9个月时，疾病活动度评分-28有显著改善，而在3、6和9个月时，银屑病面积和严重程度指数与基线相比有显著差异。巴斯强直性脊柱炎疾病活动指数在9个月和12个月时与基线相比有显著差异。疼痛评分在9个月和12个月时有改善趋势，身体状况部分在6个月和9个月时有显著改善，社会状况部分在12个月时有显著改善（简明健康调查问卷生活质量评分）。对于文献综述，共识别出35篇文章，但最终仅考虑了17篇论文。
司库奇尤单抗在多项现实世界研究中已证明对PsA治疗有效。以患者为导向和以临床医生为导向的结果均显示该治疗有显著改善。本次现实世界评估为司库奇尤单抗用于PsA治疗增加了进一步证据，表明合并症患者对PsA治疗有快速、安全、具有临床意义且持续的反应。
