Rheumatology Drugs at a Glance, Part 1: Psoriatic Arthritis

treated patients during clinical trials. Discontinue brodalumab if this develops.

Commentary: The most common adverse reactions (≥3%) are arthralgia and nausea.

Ixekizumab (Taltz):²⁴ Injection

Drug class: monoclonal antibody, IL-17RA

Warnings & Precautions

• Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of a clinically important chronic or acute infection occur. If a serious infection develops, discontinue ixekizumab until the infection resolves.
• Evaluate for TB prior to initiating treatment.
• If a serious hypersensitivity reaction occurs, discontinue ixekizumab immediately and initiate appropriate therapy.
• IBD, including exacerbations, occurred during clinical trials. Patients who are treated with ixekizumab and have IBD should be monitored closely.

Commentary: The FDA approval of ixekizumab for active PsA was based on two randomized, controlled clinical trials that included more than 670 adult patients. The most common adverse reactions (≥1%) are injection-site reactions, upper respiratory tract infections, nausea and tinea infections.

Secukinumab (Cosentyx):²⁵ Injection

Drug class: Monoclonal antibody, IL-17 RA

Warnings & Precautions

• Serious infections have occurred. Caution should be exercised when considering using secukinumab for patients with a chronic infection or a history of recurrent infection. If a serious infection develops, discontinue the drug until the infection resolves.
• Prior to initiating treatment with secukinumab, evaluate for TB.
• Caution should be exercised when prescribing secukinumab to patients with IBD; cases of IBD were observed in clinical trials.
• If an anaphylactic reaction or other serious hypersensitivity reaction occurs, discontinue secukinumab immediately and initiate appropriate therapy.

Commentary: A new study (analysis of results from an earlier clinical trial) further confirms the efficacy of secukinumab.²⁶ The study uses a new assessment tool called Psoriatic Arthritis Disease Activity Score (PASDAS), which is more comprehensive than other evaluation tools. According to the new analysis, PsA patients who used secukinumab were more likely to achieve remission or low disease activity, as defined by PASDAS, after 16 weeks than those using a placebo. They were also more likely to stay in remission or low disease activity states for a two-week period. The most common adverse reactions (≥1%) are nasopharyngitis, diarrhea and upper respiratory tract infection.

Mary Choy, PharmD, BCGP, FASHP, is a medical writer and editor living in New York City. Dr. Choy is director of pharmacy practice at the New York State Council of Health-System Pharmacists.

References

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6. The National Psoriasis Foundation. Financial assistance resource center.
7. FDA website. Otezla prescribing information. 2017 Jun.
8. FDA website. Enbrel prescribing information. 2018 May.
9. FDA website. Erelzi prescribing information. 2016 Aug.
10. FDA website. Remicade prescribing information. 2018 Jun.
11. FDA website. Inflectra prescribing information. 2018 Jul.
12. FDA website. Renflexis prescribing information. 2019 Mar.
13. FDA website. Ixifi prescribing information. 2017 Dec.
14. FDA website. Humira prescribing information. 2018 Dec.
15. FDA website. Amjevita prescribing information. 2018 Mar.
16. FDA website. Cyltezo prescribing information. 2017 Aug.
17. FDA website. Hyrimoz prescribing information. 2018 Oct.
18. FDA website. Cimzia prescribing information. 2019 Feb.
19. FDA website. Simponi prescribing information. 2018 Mar.
20. FDA website. Orencia prescribing information. 2017 Dec.
21. FDA website. Stelara prescribing information. 2018 Jun.
22. FDA website. Xeljanz prescribing information. 2018 May.
23. FDA website. Siliq prescribing information. 2017 Feb.
24. FDA website. Taltz prescribing information. 2018 May.
25. FDA website. Cosentyx prescribing information. 2018 Jan.
26. Coates LC, Gladman DD, Nash P, et al. Secukinumab provides sustained PASDAS-defined remission in psoriatic arthritis and improves health-related quality of life in patients achieving remission: 2-year results from the phase III FUTURE 2 study. Arthritis Res Ther. 2018 Dec;20(1):272.