MedNet.nl: Gonul Hazal Koc (Erasmus MC) presented results from the STAMP study of T2T strategies in PsA. Early treatment with secukinumab led to a significant clinical response within 3 months. Less frequent medication escalation was needed in the secukinumab group than in the group with standard care. After 1 year, similar, improved outcomes had been achieved in both groups.
Treat-to-target (T2T) strategies can improve outcomes for patients with psoriatic arthritis (PsA), yet T2T adoption is limited. In the multicenter STAMP trial, Koc and her colleagues examined the effectiveness and safety of early, intensive treatment of PsA with T2T.
They included 120 patients newly diagnosed with PsA who met CASPAR criteria and had a Swollen Joint Count of 66 Joints (SJC66) of at least 2. They were randomized to standard care (SoC; n=60) or early secukinumab (eSEC; n=60), both according to T2T. The eSEC group began treatment with secukinumab (300 mg/4 weeks), methotrexate (MTX; oral 15 mg/week), and methylprednisolone (MP; single injection 80 mg); the SoC group began with the same doses of MTX and MP. In both groups, treatment was intensified after 3 months if there was no 50% improvement in SJC66, and after months 6 and 9 if minimal disease activity (MDA) was not achieved.
After 12 months, the eSEC group showed that more patients remained on their initial treatment regimen than the SoC group (58 vs 35%). Compared with SoC, significantly more patients with eSEC achieved ACR50 (43 vs 22%; RR=2.00; 95% CI 1.14–3.51) and ACR20 (65 vs 40%; RR=1.62; 95% CI 1.13–2.33) after 3 months. However, after 12 months, the ACR50 response was similar (eSEC 50%; SoC 50%) and the same was true for the ACR20 and ACR70.
There was no difference in adverse events (38.7 vs 41.9%) and dropout due to adverse events (0.0 vs 0.2%). No new safety signals were observed.
This article was originally published in Dutch on MedNet.nl