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Secukinumab Reduces Flare Risk in Juvenile PsA and ERA

— Eric Ruderman, MD, discusses the JUNIPERA study

MedpageToday

Secukinumab (Cosentyx) was effective in treating children and adolescents with psoriatic arthritis (PsA) and enthesitis-related arthritis (ERA), resulting in a significantly longer time to flare versus placebo, at the American College of Rheumatology (ACR) virtual meeting.

In this video courtesy of , , of Northwestern University Feinberg School of Medicine in Chicago, describes the design and results of the JUNIPERA study.

Following is a transcript of his remarks:

You know, the pediatricians have had challenges over the years as they don't have as many options for their kids as we do for our adult patients. And interestingly, actually at this very same meeting, there's a in pediatric psoriatic arthritis.

So they've had biologics, but they haven't had anything other than TNF inhibitors, and it's really nice to see good data with other mechanisms in the pediatric population.

This particular study was run much like a lot of the other pediatric studies in which all the kids got active drug initially and then those kids who responded were randomized to stay on active drug or switched to placebo. They do this that way because that minimizes the amount of time that a kid may be on placebo and not be actively treated.

This study looked at 86 kids with either emphysematous-related arthritis, which is essentially juvenile spinal arthritis or juvenile psoriatic arthritis. And the highlights were that all of these kids either currently or previously had some enthesitis, which is a major feature of both of those diagnoses. And they were treated with open-label secukinumab weekly for 5 weeks with a dosing based on weight.

And then they got another dose at the 8-week time point. And then at 12 weeks, those kids who were doing well, who had responded with a JIA [juvenile idiopathic arthritis] ACR30 [30% improvement on the criteria of the ACR response], which is a joint response, 87% of those kids were then randomized to switch to placebo or stay on the secukinumab in a blinded fashion.

And the primary endpoint was time to flare after randomization. And there was a dramatic difference between the secukinumab group and the placebo group. With the placebo group having a medium time to flare after randomization of just over a year, the secukinumab group didn't even hit a medium time because they kept responding.

Safety data was very consistent with the safety of secukinumab in adults. And so I think that the key point of this study -- which was initially presented as a late breaker at EULAR [European Alliance of Associations for Rheumatology] last summer, but this is the first time that many in the U.S. audience are seeing it -- the key takeaway from the study is that it's really nice to see good data with another mechanism of action in these children with pediatric psoriatic arthritis, as well as the spinal arthritis.

This data will presumably help them as it gets into the label, getting approval for these drugs for kids.

And hopefully this is just the first of additional data to come looking at other mechanisms so that ... they're not limited to one target in these pediatric patients.

That's it for me for ACR Convergence 2021, but check out for lots more information about this meeting, lots of interesting insights about the data presented.

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    Greg Laub is the Senior Director of Video and currently leads the video and podcast production teams.