Efficacy and safety of secukinumab (Cosentyx) in patients with juvenile psoriatic arthritis

Psoriatic arthritis is a chronic inflammatory disease of the peripheral joints, spinal joints and entheses, occurring in 10–25% of patients with psoriasis. Juvenile psoriatic arthritis is classified as a subtype of juvenile idiopathic arthritis. Treatment of juvenile psoriatic arthritis is challenging. One of the main difficulties is that the drugs used in adult patients have restrictions for use in pediatric practice, which limits the available therapeutic options. There are few studies assessing the effectiveness and safety of secakinumab therapy in pediatric practice. Objective . To evaluate the effectiveness and safety of secukinumab (Cosentyx) therapy in children with juvenile psoriatic arthritis in real clinical practice. Methods . The effectiveness of therapy was assessed using the “pediatric” criteria of the American College of Rheumatology (ACRpedi) after 6, 12 and 18 months from the date of administration of secuquinumab (Cosentyx) therapy in 8 patients with jPsA. The main criterion for treatment effectiveness was the achievement of at least 50% (ACR pedi 50) improvement. To assess the area and severity of skin manifestations of psoriasis, the PASI (Psoriasis Area Severity Index) index was used. To assess the area of skin affected by psoriatic rashes, the body surface area index (BSA) was used. Results . By the 6th month of therapy with secukinumab (Cosentyx), a general assessment of the effectiveness of treatment was completed in all children (n-8): ACRpedi50 in 1 (12.5%), ACRpedi70 in 3 (37.5%); ACRpedi90/100 in 4 (50%). By the 12th month of therapy with secukinumab (Cosentyx), according to a comprehensive assessment of the effectiveness of therapy, all remaining children (n-5) responded to treatment: ACRpedi70/90/100 were 60/60/60%. Inactive disease status was achieved in 60% of cases. By the 18th month from the start of therapy, ACRpedi was assessed in 5 children: ACRpedi 70/90/100 were 60/60/60%, respectively. In 3 patients from the initial number of children, pharmacological clinical and laboratory remission of the disease was achieved by the 18th month of therapy.