Treatment with the anti–interleukin-17A monoclonal antibody secukinumab may result in higher rates of sustained remission in patients with active giant cell arteritis, according to a novel study published by Venhoff et al in The Lancet Rheumatology. In the phase II TitAIN study (ClinicalTrials.gov identifier NCT03765788), researchers randomly assigned 52 patients with a median age of 75 years who had new-onset or relapsed giant cell arteritis—and were already taking glucocorticoids and 25 to 60 mg per day of prednisolone—to receive either 300 mg of secukinumab or placebo once weekly for 4 weeks followed by doses once every 4 weeks. The primary endpoint was the median proportion of patients who had sustained remission until 28 weeks. The researchers discovered that 70% (95% confidence interval [CI] = 52%–85%) of the patients who received secukinumab vs 20% (95% CI = 12%–30%) of those who received placebo achieved sustained remission at week 28 of the trial. Additionally, 100% of patients in the secukinumab group and 96% of those in the placebo group experienced adverse events, the most common being hypertension (22% in the secukinumab group and 32% in the placebo group) and nasopharyngitis (19% vs 20%). Two patients in each treatment group died, but no deaths were considered related to treatment. The researchers concluded that secukinumab was effective at sustaining remission and well tolerated in patients with giant cell arteritis and that these findings support the development of the agent as a treatment option for this patient population.
June 30, 2023