Low Risk of TB with Secukinumab Save

JAMA Dermatology has reported on a longitudinal cohort study of 12,319 secukinumab (SEC) treated patients (psoriasis, psoriatic arthritis, or ankylosing spondylitis); no new cases of active tuberculosis (TB) and very few cases of latent tuberculosis infection (LTBI) were found. 

Pooled data from 28 SEC clinical trials of secukinumab used in psoriasis (17 phase 3 or 3b and 2 phase 4 trials), psoriatic arthritis (5 phase 3 trials), and ankylosing spondylitis (4 phase 3 trials). Before treatment all patients underwent screening for TB and those with active TB were excluded, and patients with LTBI were treated according to local guidelines and allowed to participate.

Among 12 319 patients there were 8819 psoriasis, 2523 psoriatic arthritis and 977 had ankylosing spondylitis patients.  Overall, 684 patients (5.6%) had tested positive for LTBI at screening.

After 5 years, LTBI as an AE during secukinumab treatment was reported in 13 patients (0.1%); 6 had a prior positive LTBI test and 7 were newly diagnosed as having LTBI (4 PSO, 1 PsA, 2 AS).  No cases of active TB were reported.

LTBI after secukinumab treatment was uncommon and no cases of active TB on SEC suggests the TB risk with SEC to be very low.