Minimal disease activity (MDA) in psoriatic arthritis (PsA)

Cosentyx® (secukinumab) is indicated for the treatment of: moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adults (alone or in combination with methotrexate [MTX]) who have responded inadequately to disease-modifying anti-rheumatic drug therapy.¹

Full indication for Cosentyx can be found here.

Cosentyx Summary of Product Characteristics (SmPC) can be found here.

Remission is a poorly defined and variable outcome measure in PsA^2,3

PsA is a complex disease comprising six key manifestations: joints, axial, skin, enthesitis, dactylitis and nails.^4,5 These are known to cause fatigue, pain and impairment of daily functions, resulting in compromised quality of life.⁶
Due to its multifaceted clinical presentation, assessment of disease activity can be challenging.⁵

There is a need for a measure to accurately monitor disease activity across multiple PsA domains to assess holistic disease burden^7,8

MDA
Achieving MDA early
MDA with Cosentyx

EULAR and BSR guidelines recommend targeting remission or low disease activity in PsA^9,10

The MDA score is a validated, composite measure that allows the assessment of low disease activity^5,9,11

The MDA score is made up of multiple criteria that encompass important aspects of PsA, including joint and skin activity, physical function and pain.⁸ Patients achieve MDA by meeting 5 of 7 of the following criteria:^2,8

What could MDA mean to your eligible patients?

Achieving MDA early is important for long-term outcomes¹²

Patients who achieved MDA in the first year after their diagnosis demonstrated improved  long-term outcomes, including pain, fatigue and emotional wellbeing¹²

Potential barriers to achieving MDA in patients with PsA

Skin involvement²

High enthesitis count/dactylitis at baseline²

Long-term disease resulting in irreversible damage¹³

Functional impairment²

Comorbidities such as metabolic syndrome, hepatic steatosis and fibromyalgia²

At 2 years, MDA is more likely to be achieved by those who do not have radiographic progression¹⁴

FUTURE 5 trial: The primary endpoint (ACR20 response at Week 16) was met (Cosentyx 300 mg with loading dose 62.6% vs placebo 27.4%, p<0.0001).¹⁵

Are you choosing a treatment with MDA in mind?

Sustained MDA could be achievable for your eligible adult patients with PsA^16,17

SUSTAINED: results up to Year 5.¹⁷

Graphic highlighting findings from the FUTURE 1 study, in which 39.5% of TNFi-naive patients achieved MDA at 5 years with Cosentyx 150 mg SC (n=195)¹⁷

Graphic highlighting findings from the FUTURE 5 study, in which 41.2% of TNFi-IR patients achieved MDA at 2 years with Cosentyx 300 mg SC (n=51)¹⁶

Efficacy in PsA

Efficacy in axSpA

Efficacy in JIA

Safety profile

Dosing

Mechanism of action

Contact us

HCP resources

Therapeutic Indications¹
Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adult patients (alone or in combination with methotrexate [MTX]) when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate; active ankylosing spondylitis (AS) in adults who have responded inadequately to conventional therapy; active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation as indicated by elevated C-reactive protein and/or magnetic resonance imaging evidence in adults who have responded inadequately to non-steroidal anti-inflammatory drugs; active moderate to severe hidradenitis suppurativa (HS; acne inversa) in adults with an inadequate response to conventional systemic HS therapy; active enthesitis-related arthritis (ERA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy; active juvenile psoriatic arthritis (JPsA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.¹

Study designs
FUTURE 5: A randomised, double-blind, Phase III study in patients with active moderate to severe PsA (N=996) randomised to receive Cosentyx 150 mg without loading dose (n=222), Cosentyx 150 mg with loading dose (n=220), Cosentyx 300 mg with loading dose (n=222) or placebo (n=332). The primary endpoint was the percentage of patients with ACR20 response at Week 16.¹⁵

FUTURE 1: A multicentre, randomised, double-blind, placebo-controlled, Phase III study in patients with active PsA (N=606) randomised to receive Cosentyx or placebo. Patients in the Cosentyx group received an IV dose of 10 mg/kg of body weight at baseline, Week 2 and Week 4, followed by SC Cosentyx 150 mg or 75 mg every 4 weeks thereafter. The primary endpoint was the percentage of patients with ACR20 response at Week 24.¹⁸

Cosentyx is not currently available as an IV treatment.

Please note, Cosentyx should not be used without a loading dose, and the Cosentyx 75 mg dose is not licensed for PsA. The recommended dose for TNFi-IR is 300 mg by SC injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing. For other patients, the recommended dose is 150 mg by SC injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing. Based on clinical response, this can be increased to 300 mg.¹

Cosentyx has not been studied in renal/hepatically impaired patient populations. No dose recommendations can be made.¹

For patients with concomitant moderate to severe PsO, please refer to adult PsO recommendations in the Cosentyx SmPC.¹

ACR, American College of Rheumatology; AS, ankylosing spondylitis; BSA, body surface area; BSR, British Society for Rheumatology; ERA, enthesitis-related arthritis; EULAR, European Alliance of Associations for Rheumatology; HAQ-DI, health assessment questionnaire-disability index; HS, hidradenitis suppurativa; IR, inadequate responder; IV, intravenous; JPsA, juvenile psoriatic arthritis; MDA, minimal disease activity; MTX, methotrexate; nr-axSpA, non-radiographic axial spondyloarthritis; PASI, psoriasis area and severity index; PsA, psoriatic arthritis; PsO, plaque psoriasis; SC, subcutaneous; SmPC, summary of product characteristics; TNFi, tumour necrosis factor inhibitor; VAS, visual analogue scale.

References

Cosentyx® (secukinumab) Summary of Product Characteristics.
Gossec L et al. J Rheumatol 2018;45(1):6–13.
Lubrano E, et al. Clin Exp Rheumatol 2018;36(5):900–910.
Baraliakos X, et al. Ann Rheum Dis 2021;80(5):582–590.
McGagh D & Coates LC. Rheumatology 2020;59(Suppl 1):i29–i36.
Skougaard M, et al. Rheum Adv Pract 2021;5(3):rkab076.
Hackett S & Coates LC. Musculoskeletal Care 2022;20(Suppl 1):S22–S31.
Coates LC, et al. Ann Rheum Dis 2010;69(1):48–53.
Gossec L, et al. Ann Rheum Dis 2020;79(6):700–712.
Tucker L, et al. Rheumatology 2022;61(9):e255–e266.
Scriffignano S, et al. Abstract AB1135. Ann Rheum Dis 2023;82(Suppl 1):1798.
Henkemans SVJS, et al. RMD Open 2022;8(2):e002706.
Mease PJ, et al. RMD Open 2017;3(1):e000415.
Mease PJ, et al. Abstract POS0972. Ann Rheum Dis 2024;83(Suppl1):682–683.
Mease PJ, et al. Ann Rheum Dis 2018;77(6):890–897.
Novartis Data on File. CAIN457F2342 (FUTURE 5): Week 104 Interim Report. May 2019.
Mease PJ, et al. ACR Open Rheumatol 2020;2(1):18–25.
Mease PJ, et al. N Engl J Med 2015;373(14):1329–1339.

UK | July 2025 | FA-11426990

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