Cosentyx (secukinumab, Novartis) is a better and cheaper treatment for psoriatic arthritis in the United States than Humira (adalimumab, AbbVie), a study has concluded.
The research, “Comparison of Secukinumab Vs Adalimumab in a Cost per Responder Analysis Based on a Matching-Adjusted Indirect Comparison of Efficacy Data for the Treatment of Psoriatic Arthritis at 48 Weeks from the US Perspective,” was presented at the American College of Rheumatology Annual Meeting.
A New York University School of Medicine team led by Dr. Jeffrey D. Greenberg used the American College of Rheumatology scale (ACR 20/50/70) to determine patient outcomes after 48 weeks
The ACR reports a patient’s percentage of improvement by comparing disease activity at two points, usually when treatment begins and ends. An ACR20 score means patients had at least a 20% improvement in disease activity. ACR50 means at least a 50% improvement, and ACR70 at least 70%.
Researchers arrived at a treatment cost per patient by dividing the cost of each therapy by the treatment response rate over 48 weeks. They used official U.S. prices for the cost figures.
Data was retrieved from two psoriatic-arthritis clinical trials. The FUTURE 2 trial (NCT01752634), evaluated the long-term safety, effectiveness and tolerability of Cosentyx. The ADEPT (NCT00195689) trial evaluated the long-term safety and effectiveness of Humira.
Matching-adjusted indirect comparison analysis of the trials’ data was used to estimate long-term responses. It matched trial participants’ age, weight, race and gender distribution, psoriasis area and severity index (PASI) scores, and health assessment questionnaire-disability index (HAQ-DI) scores.
The analysis also took into account the duration of the disease; swollen joint count; C-reactive protein (CRP); proportion of patients using methotrexate whose psoriasis affected more than 3% of their body; whether a patient had dactylitis, or inflammation of a finger or toe; whether a patient had enthesitis, or inflammation of soft tissue; and a patient having had no treatment with TNF inhibitors before the study started.
Matching the baseline characteristics gave researchers sample sizes of 15 patients on 150 mg of Cosentyx, 25 patients on 300 mg of Cosentyx, and 151 patients on Humira.
At 48 weeks, the ACR (20/50/70) response rates were significantly higher for patients treated with both doses of Cosentyx than patients treated with Humira, the researchers reported.
The ACR20 response rates were 79% for those on 150 mg of Cosentyx, 82% for those on 300 mg of Cosentyx, and 56% for those on Humira. The ACR50 response rates were 68%, 73% and 44%, and the ACR70 response rates 39%, 50% and 30%.
Sensitivity analysis also showed higher response rates for both doses of Cosentyx than for Humira.
The cost per ACR 20 patient for those on 150 mg of Cosentyx was $72,906, for those on 300 mg of Cosentyx $70,993, and for those on Humira $80,412. The costs per ACR50 patient were $85,480, $79,760 and $103,561, and the costs per ACR70 patient $150,276, $115,934 and $151,890.
“These findings indicate that secukinumab represents a cost-efficient treatment choice for [psoriatic arthritis] PsA patients in the U.S.,” the researchers wrote in a news release.