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Exploring Updated Treatment Recommendations for Psoriatic Arthritis

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Select video hot spots to learn about the updated GRAPPA 2021 guidelines and treatment recommendations for key clinical domains of psoriatic arthritis.

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Important Safety Information

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  • Overview

    As a founding organizer of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), Dr Philip Mease helped develop treatment recommendations for patients with psoriatic arthritis (PsA).

    Dr Mease discusses the key clinical manifestations of PsA and their impact on patients. He also highlights the latest GRAPPA treatment recommendations for each of these six domains of PsA: peripheral arthritis, axial symptoms, enthesitis, dactylitis, skin psoriasis, and nail psoriasis.

    The interactive format enables you to choose which domains of PsA to explore, and each section includes a review of clinical trial data for COSENTYX® (secukinumab).

    Study design and primary end points can be accessed here.

    Dr Mease is speaking about the GRAPPA recommendations on behalf of Novartis Pharmaceuticals Corporation. The perspectives he is sharing are his own.

    Dr Mease was compensated for his time.

    Novartis is one of the many corporate supporters of the GRAPPA network.

  • INDICATIONS

    COSENTYX® (secukinumab) is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in patients 6 years and older who are candidates for systemic therapy or phototherapy.

    COSENTYX is indicated for the treatment of active psoriatic arthritis (PsA) in patients 2 years of age and older.

    COSENTYX is indicated for the treatment of adult patients with active ankylosing spondylitis (AS).

    COSENTYX is indicated for the treatment of adult patients with active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation.

    COSENTYX is indicated for the treatment of active enthesitis-related arthritis (ERA) in patients 4 years of age and older.

    COSENTYX is indicated for the treatment of adult patients with moderate to severe hidradenitis suppurativa (HS).

  • IMPORTANT SAFETY INFORMATION

    CONTRAINDICATIONS
    COSENTYX is contraindicated in patients with a previous serious hypersensitivity reaction to secukinumab or to any of the excipients in COSENTYX. Cases of anaphylaxis and angioedema have been reported during treatment with COSENTYX.

    WARNINGS AND PRECAUTIONS
    Infections
    COSENTYX may increase the risk of infections. In clinical trials, a higher rate of infections was observed in COSENTYX treated subjects compared to placebo-treated subjects. In placebo-controlled clinical trials in subjects with moderate to severe PsO, higher rates of common infections, such as nasopharyngitis (11.4% versus 8.6%), upper respiratory tract infection (2.5% versus 0.7%) and mucocutaneous infections with candida (1.2% versus 0.3%) were observed in subjects treated with COSENTYX compared to placebo-treated subjects. A similar increase in risk of infection in subjects treated with COSENTYX was seen in placebo-controlled trials in subjects with PsA, AS and nr-axSpA. The incidence of some types of infections, including fungal infections, appeared to be dose-dependent in clinical trials.

    In the postmarketing setting, serious bacterial, viral, and fungal opportunistic infections, and some fatal infections have been reported in patients receiving IL-17 inhibitors including COSENTYX. Cases of Hepatitis B virus reactivation have been reported.

    Exercise caution when considering the use of COSENTYX in patients with a chronic infection or a history of recurrent infection. Instruct patients to seek medical advice if signs or symptoms suggestive of an infection occur. If a patient develops a serious infection, monitor the patient closely and discontinue COSENTYX until the infection resolves.

    If signs of Hepatitis B virus reactivation occur, consult a hepatitis specialist. COSENTYX is not recommended for use in patients with active viral hepatitis.

    Pre-treatment Evaluation for Tuberculosis
    Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with COSENTYX. Avoid administration of COSENTYX to patients with active TB infection. Initiate treatment of latent TB prior to administering COSENTYX. Consider anti-TB therapy prior to initiation of COSENTYX in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients closely for signs and symptoms of active TB during and after treatment.

    Inflammatory Bowel Disease
    Inflammatory Bowel Disease (IBD) exacerbations, in some cases serious and/or leading to discontinuation of COSENTYX, occurred in COSENTYX treated subjects during clinical trials in PsO, PsA, AS, nr-axSpA, and HS. In adult subjects with HS, the incidence of IBD was higher in subjects who received COSENTYX 300 mg every 2 weeks (Ulcerative Colitis [UC] 1 case, EAIR 0.2/100 subject-years; Crohn’s Disease [CD] 1 case, EAIR 0.2/100 subject-years) compared to subjects who received COSENTYX 300 mg every 4 weeks (IBD 1 case, EAIR 0.2/100 subject-years). In addition, new onset IBD cases occurred in subjects treated with COSENTYX in clinical trials. In an exploratory trial in 59 subjects with active Crohn’s disease [COSENTYX is not approved for the treatment of Crohn’s disease], there were trends toward greater disease activity and increased adverse reactions in subjects treated with COSENTYX as compared to placebo-treated subjects.

    Exercise caution when prescribing COSENTYX to patients with IBD. Patients treated with COSENTYX should be monitored for signs and symptoms of IBD.

    Eczematous Eruptions
    In postmarketing reports, cases of severe eczematous eruptions, including atopic dermatitis-like eruptions, dyshidrotic eczema, and erythroderma, were reported in patients receiving COSENTYX; some cases resulted in hospitalization. The onset of eczematous eruptions was variable, ranging from days to months after the first dose of COSENTYX.

    Treatment may need to be discontinued to resolve the eczematous eruption. Some patients were successfully treated for eczematous eruptions while continuing COSENTYX.

    Hypersensitivity Reactions
    Serious hypersensitivity reactions including anaphylaxis, angioedema, and urticaria have been reported in COSENTYX treated subjects in clinical trials and in the post-marketing setting. If an anaphylactic or other serious allergic reaction occurs, immediately discontinue administration of COSENTYX and initiate appropriate therapy.

    The removable caps of the COSENTYX Sensoready® pen and the COSENTYX 1 mL and 0.5 mL prefilled syringes contain natural rubber latex, which may cause an allergic reaction in latex-sensitive individuals. The safe use of the COSENTYX Sensoready pen or prefilled syringe in latex-sensitive individuals has not been studied.

    Immunizations
    Prior to initiating therapy with COSENTYX, consider completion of all age-appropriate immunizations according to current immunization guidelines. COSENTYX may alter a patient’s immune response to live vaccines. Avoid use of live vaccines in patients treated with COSENTYX.

    MOST COMMON ADVERSE REACTIONS
    Most common adverse reactions (>1%) are nasopharyngitis, diarrhea, and upper respiratory tract infection.

    Please see full Prescribing Information, including Medication Guide.

    Sponsored by Novartis Pharmaceuticals Corporation

     

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Schedule12 Dec 2024