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Psoriatic arthritis and secukinumab No better than adalimumab, and with more limited follow-up

机译：银屑病关节炎和Secukinumab不得比Adalimumab更好，随访更有限

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In a randomised, double-blind trial comparing secukinumab versus adalimumab in 853 patients with psoriatic arthritis, secukinumab was not shown to have greater efficacy in relieving joint symptoms, nor fewer adverse effects overall. The adverse effects of these two drugs appeared to be similar and mainly related to their immunosuppressive actions. In patients with psoriatic arthritis, when a nonsteroidal anti-inflammatory drug is not sufficiently effective, methotrexate, a so-called conventional immunosuppressant with cytotoxic properties, is a first choice "disease-modifying" treatment. If methotrexate is not sufficiently effective or its adverse effects are too troublesome, a anti-TNF-alpha immunosuppressant such as adalimumab is an option (1-3). Secukinumab is an anti-interleukin-17A immunosuppressant. It is authorised in particular for patients with psoriatic arthritis who have already received at least one other "disease-modifying" treatment which was considered insufficiently effective. Its initial clinical evaluation for use in this setting had not, thus far, included a trial comparing it with a TNF-alpha inhibitor (2). Results of atrial comparing secukinumab versus adalimumab in patients with psoriatic arthritis were published in 2020 (4).
机译：在一项随机双盲试验中，对853例银屑病关节炎患者进行了塞库单抗与阿达木单抗的比较，结果表明，塞库单抗在缓解关节症状方面没有更大的疗效，总体上也没有更少的不良反应。这两种药物的副作用似乎相似，主要与它们的免疫抑制作用有关。在银屑病性关节炎患者中，当非甾体抗炎药不够有效时，甲氨蝶呤（一种具有细胞毒性的传统免疫抑制剂）是首选的“疾病改善”治疗。如果甲氨蝶呤不够有效或其副作用太麻烦，可以选择抗TNF-α免疫抑制剂，如阿达木单抗（1-3）。塞库单抗是一种抗白细胞介素-17A免疫抑制剂。它尤其适用于银屑病关节炎患者，这些患者已经接受了至少一种被认为不够有效的“疾病改善”治疗。到目前为止，其用于该环境的初步临床评估尚未包括将其与TNF-α抑制剂进行比较的试验（2）。在银屑病关节炎患者中比较塞库单抗和阿达木单抗的结果发表于2020年（4）。

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    《Prescrire international》 |2021年第222期|共1页
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