Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID)

BACKGROUND

Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections.

METHODS

A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC.

RESULTS

Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts.

CONCLUSIONS

Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.

POS0649 EFFICACY AND SAFETY OF LEVILIMAB IN COMBINATION WITH METHOTREXATE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: 1-YEAR RESULTS OF PHASE III, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL

Background

Previously, 24-week results of phase III double-blind, placebo-controlled randomized clinical study (SOLAR) of levilimab in subjects with active rheumatoid arthritis (RA) proved a superiority of levilimab over placebo1. Here we present 1-year efficacy and safety data of the open-label period of the SOLAR study.

Objectives

To evaluate the efficacy and safety of levilimab in combination with methotrexate (MTX) in subjects with MTX resistant active RA.

Methods

The study was conducted at 21 clinical sites in Russia and Belarus. All randomized subjects had completed the study between November 2019 and October 2021.

154 adults, aged ≥ 18 years with confirmed diagnosis of RA1 were randomly assigned (2:1) to receive either levilimab, 162 mg, SC (LVL QW) + MTX (n=102) or placebo (PBO) + MTX (n=52).

After W24 of the study all subjects continued to receive open label levilimab +MTX. Subjects who had achieved DAS28-CRP ≤ 2.6 at W24 were switched to maintenance (Q2W) regimen of levilimab + MTX at W28: LVL QW/Q2W arm (n=27) and PBO/LVL Q2W arm (n=1). Those with DAS28-CRP > 2.6 at W28 continued with levilimab QW regimen + MTX: LVL QW/QW arm (n=75) and PBO/LVL QW arm (n=51).

The efficacy analysis was done in a population of all randomized subjects (n=154). Those with missing data due to study discontinuation or rescue therapy prescription were considered non-responders. Otherwise, the analysis was performed on complete cases.

Safety was assessed through monitoring of adverse events (AEs) in a population of those, who received at least one dose of LVL (n=152). Two subjects randomized to receive placebo were discontinued within first 24 weeks of the study, thus did not received any dose of levilimab and were excluded from safety analysis.

Results

Obviously, better response to the treatment was observed in LVL QW/Q2W arm as it was composed of those who had reached DAS28-CRP ≤ 2.6 at W24. At this time point 15/27 (55.6%) of them achieved ACR70; 23/27 (85.2%) achieved DAS28-CRP remission (< 2.6) and 7/27 (25.9%) achieved ACR/EULAR2011 remission of RA. After switching to LVL Q2W, rates of ACR70 and DAS28-CRP < 2.6 did not significantly changed until W52: 17/27 (63.0%) and 21/27 (77.8%), respectively, yet the proportion of subject with ACR/EULAR 2011 remission further increased and reached 12/27 (44.4%).

LVL QW/QW arm was diminished by subjects who had achieved high response to treatment at W24 and composed LVL QW/Q2W arm. Thus, the ACR70, and remissions rate in this arm were close to zero at W24. However, continuation of LVL QW in those who had not achieved DAS28-CRP ≤ 2.6 at W24 induced ACR70 response in 37/75 (36.0%), DAS28-CRP remission in 35/75 (46.7%) and ACR/EULAR 2011 remission in 8/75 (10.7%) at W52.

The most common adverse events (reported in ≥5% of subjects) were blood cholesterol increase (30.3%), ALT increase (23.0%), lymphocyte count decrease (17.1%), ANC decrease (16.4%). blood triglycerides increase (13.8%), bilirubin increase (11.2%), AST increase (9.9%), WBC decrease (9.9%), IGRA with M.tb antigen positive (7.2%) and injection site reactions (5.9%). No deaths were occurred.

Conclusion

Open label period confirmed the lasting efficacy and safety of levilimab in combination with MTX in subjects with MTX resistant active RA and suggested the possibility of switching to maintenance (Q2W) regimen of levilimab in those who achieved remission of RA at week 24.

Trial registration: Clinicaltrials.gov identifier NCT04397562

References

[1]Mazurov V, Korolev M, Kundzer A, et al POS0624 EFFICACY AND SAFETY OF LEVILIMAB IN COMBINATION WITH METHOTREXATE IN SUBJECTS WITH ACTIVE RHEUMATOID ARTHRITIS: PHASE III, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL Annals of the Rheumatic Diseases 2021;80:550-551.

Acknowledgements

We thank all contributors to the SOLAR clinical trial

Disclosure of Interests

V Mazurov: None declared, Maxim Korolev: None declared, Andrei Pristrom: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Aleksander Kastanayan: None declared, Tatyana Povarova: None declared, Tatyana Plaksina: None declared, Olga Antipova: None declared, Diana Kretchikova: None declared, Svetlana Smakotina: None declared, Oksana Tciupa: None declared, Ekaterina Puntus: None declared, Tatiana Raskina: None declared, Ludmila Shilova: None declared, Tatyana Kropotina: None declared, Olga Nesmeyanova: None declared, Tatiana Popova: None declared, Irina Vinogradova: None declared, Iulia Linkova Employee of: JSC BIOCAD, Aleksandra Plotnikova Employee of: JSC BIOCAD, Polina Pukhtinskaia Employee of: JSC BIOCAD, Arina Zinkina-Orikhan Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD, Anton Lutckii Employee of: JSC BIOCAD

OP0142 NETAKIMAB REDUCES ANKYLOSING SPONDYLITIS ACTIVITY IN PATIENTS WITH OR WITHOUT SACROILIITS ON MRI: RESULTS OF SUBANALYSIS OF PHASE 3 ASTERA TRIAL

Background:

The presence of sacroiliitis in patients (pts) with ankylosing spondylitis (AS) on imaging can be established both by sacroiliac joint (SIJ) X-ray or MRI. Active sacroiliitis on MRI as defined by ASAS is predictor of good treatment response to biological disease modifying anti-rheumatic drugs [1, 2]. Netakimab (NTK) is a humanized anti-interleukin-17A antibody approved for the treatment of AS, psoriatic arthritis, moderate-to-severe plaque psoriasis in Russia and Belarus. The difference in treatment response to NTK in AS pts with and without active sacroiliitis on MRI (MRI+/MRI−) is unclear.

Objectives:

To report the changes in AS activity in pts with and without sacroiliitis on MRI at week 16 of NTK treatment.

Methods:

ASTERA (NCT03447704) is an ongoing phase 3 placebo (PBO)-controlled clinical study, aimed at evaluating NTK efficacy in AS. All pts fulfilled modified New York criteria. Evaluation of acute inflammation on SIJ MRI was performed at the baseline but was not an inclusion criterion. This analysis includes pts received subcutaneous NTK 120 mg every 2 wks with available baseline SIJ MRI. The presence of sacroiliitis on MRI was defined as SPARCC>2. Efficacy endpoints included ASAS20/40, ASAS partial remission (PR), changes from baseline in BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score).

Results:

67 MRI+ and 46 MRI− pts were included into analysis. Baseline characteristics were balanced across both arms. 42.4% of MRI+ pts and 38.3% of MRI− pts achieved ASAS40 at week 16 (p≥0.05), ASAS20 was observed in 65.2%/55.3% pts in the same arms respectively (p≥0.05). ASAS PR was reported for 15.2% MRI+ and 17.0% MRI− pts (p≥0.05). Improvements in BASDAI and ASDAS-CRP were similar across both arms. At wk 16, mean change from baseline in BASDAI was −2.7 vs −3.0 for MRI+ and MRI− pts respectively, mean change in ASDAS-CRP was −1.7 vs −1.4 in the same arms (p≥0.05 for all), (figure 1).

Figure 1.

Clinical improvements in AS disease activity. Mean change from baseline is shown for (A) ASDAS-CRP, and (B) BASDAI

Conclusion:

NTK leads to decline of disease activity in AS pts irrespectively of sacroiliitis on MRI.

References:

[1]Rudwaleit M, et al. MRI in predicting a major clinical response to anti-tumour necrosis factor treatment in ankylosing spondylitis. Ann Rheum Dis. 2008;67(9):1276-81.

[2]Sieper J, et al. A randomized, double-blind, placebo-controlled, sixteen-week study of subcutaneous golimumab in patients with active nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2015;67(10):2702-12.

Acknowledgements:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, V Mazurov: None declared, Shandor Erdes: None declared, Tatiana Dubinina: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Anna Eremeeva Employee of: Biocad

POS0928 NETAKIMAB EFFICACY IN ANTI-TNF-NAIVE AND ANTI-TNF-EXPERIENCED PATIENTS WITH ACTIVE ANKYLOSING SPONDYLITIS: RESULTS OF SUBANALYSIS OF PHASE 3 ASTERA TRIAL

Background:

According to previous studies, the effectiveness of interleukin-17 (IL-17) inhibitors was higher in anti-TNF-naïve patients with ankylosing spondylitis (AS) [1,2]. Netakimab (NTK) is a humanized anti-IL-17A antibody approved for the treatment of AS, psoriatic arthritis, moderate-to-severe plaque psoriasis in Russia and Belarus.

Objectives:

To compare the efficacy of NTK in anti-TNF-naïve patients with anti-TNF-experienced patients with active AS at week 16 of therapy.

Methods:

ASTERA (NCT03447704) is an ongoing phase 3 placebo (PBO)-controlled clinical study, aimed at evaluating NTK efficacy in AS [3]. 228 adult patients with active AS (BASDAI ≥ 4) were randomly assigned (1:1) to receive 120 mg NTK or PBO subcutaneously at week 0,1,2 and then q2w. This analysis includes 112 patients in NTK group. Efficacy endpoints included ASAS20/40, ASAS5/6 and ASAS partial remission (PR) at week 16 of therapy.

Results:

28 (25.0%) of 112 patients in NTK group had previous inadequate response/intolerance to anti-TNF (anti-TNF-IR): 24 (21.4%) – one anti-TNF, and 4 (3.6%) – two anti-TNF. 84 (75.0%) patients were TNF-naive. Achievement of ASAS criteria response at week 16 was similar in both groups (Table 1).

Table 1.

Efficacy of NTK at week 16

ParameterTNF-naïve (n = 84)anti-TNF-IR (n = 28)p-value*ASAS20, n (%)52 (61.9%)17 (60.7%)0.91ASAS40, n (%)35 (41.7%)11 (39.3%)0.82ASAS5/6, n (%)39 (46.4%)11 (39.3%)0.51ASAS(PR), n (%)15 (17.9%) 4 (14.3%)0.78

*- Fisher’s exact test

Conclusion:

NTK 120 mg provided sustained improvements in signs and symptoms of AS in anti-TNF-naive and anti-TNF-IR patients at 16 weeks of therapy.

References:

[1]Blair HA, Dhillon S. Secukinumab: A Review in Ankylosing Spondylitis. Drugs. 2016;76(10):1023-30.

[2]Dougados M, et al. Efficacy and safety of ixekizumab through 52 weeks in two phase 3, randomised, controlled clinical trials in patients with active radiographic axial spondyloarthritis (COAST-V and COAST-W). Ann Rheum Dis. 2020;79(2):176-185.

[3]Mazurov VI, et al. Efficacy and safety of Netakimab, anti-IL-17A monoclonal antibody, in patients with ankylosing spondylitis. Results of phase III international, multicenter, randomized double-blind clinical trial BCD-085-5/ASTERA. Nauchno-Practicheskaya Revmatologia=Rheumatology Science and Practice. 2020;58 (4):376–386 (In Russ).

Acknowledgements:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Shandor Erdes: None declared, V Mazurov: None declared, Tatiana Dubinina: None declared, Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Anna Eremeeva Employee of: Biocad

AB0534 THE IMPACT OF AXIAL INVOLVEMENT ON ACR RESPONSE IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS OF SUBANALYSIS OF THE PATERA STUDY

Background:

Inflammatory back pain (IBP) is a common symptom of axial disease in patients with psoriatic arthritis (PsA). The reported prevalence of axial disease in patients with PsA is quite variable and must be taken into account while choosing treatment strategy. Netakimab (NTK) is an anti-interleukin-17A monoclonal antibody approved for psoriasis, ankylosing spondylitis, PsA in Russia and Belarus.

Objectives:

A subanalysis was aimed to investigate the ACR (American College of Rheumatology) 20/50/70 response rate in PsA patients with/without the axial disease, defined by the presence of IBP according to self-reported ASAS IBP criteria, 2009 at baseline.

Methods:

PATERA is an ongoing phase 3 international double-blind, placebo-controlled clinical study (NCT03598751). 194 adult patients with PsA (CASPAR criteria, 2006) with inadequate response to csDMARD or one TNFi, were randomly assigned to receive NTK 120mg or placebo at weeks 0,1,2,4,6,8,10,14,18,22. The ACR response was calculated in NTK-treated patients with IBP (IBP(+)) and NTK-treated patients without IBP (IBP(-)) according to self-reported ASAS IBP criteria, 2009. Patients with missing values for categorical variables were considered as non-responders in the analysis.

Results:

97 PsA patients (N=54 IBP(+), N=43 IBP(-)) received NTK. Both subpopulations were comparable in gender, age, and PsA activity at baseline. There were no significant differences in ACR20 achievement between the groups (Figure 1). The percentage of patients with ACR50 was significantly (p<0.05) higher in the IBP(-) subpopulation at weeks 4-20 (data not shown), but not at week 24 with 63% IBP(+) and 79% IBP(-) responders (p≥0.05). Similarly, IBP(+) patients had a lower frequency of ACR70 response (Figure 1).

Conclusion:

NTK is effective in PsA treatment irrespectively of the presence of axial disease. Both IBP(-) and IBP(+) subpopulations achieved ACR20/50/70 as well, however, the benefit in IBP(-) patients was more pronounced.

Figure 1

ACR response rates

Acknowledgements:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Speakers bureau: Abbvie, Biocad, Eli Lilly, Johnson & Johnson, Janssen, Novartis, Pfizer, UCB, Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, V Mazurov: None declared., Aleksey Samtsov: None declared., Vladislav Khayrutdinov: None declared., Andrey Bakulev: None declared., Alena Kundzer: None declared., Nikolaj Soroka: None declared., Anna Eremeeva Employee of: Biocad.

POS1043 NETAKIMAB REDUCES PSORIATIC ARTHRITIS ACTIVITY IN PATIENTS WITH OR WITHOUT AXIAL DISEASE: SUBANALYSIS OF THE PATERA STUDY

Background:

PATERA is an ongoing phase 3 international double-blind, placebo-controlled clinical study of netakimab (NTK) in psoriatic arthritis (PsA) (NCT03598751). Netakimab (NTK) is an anti-interleukin-17A monoclonal antibody approved for psoriasis, ankylosing spondylitis, PsA in Russia and Belarus.

Objectives:

A subanalysis was performed to define the impact of NTK on PsA activity depending on the presence of axial disease: a subset of patients with inflammatory back pain (IBP) according to self-reported ASAS IBP criteria, 2009 (IBP(+) was compared to those without IBP (IBP(-)).

Methods:

194 eligible adult patients with PsA fulfilling the CASPAR criteria, with inadequate response to csDMARD or one TNFi, were randomly assigned to receive NTK 120mg or placebo at weeks 0,1,2,4,6,8,10,14,18,22. Patients with missing values for categorical variables were considered as non-responders in the analysis. For quantitative variables, missing values were replaced using the multiple imputation method.

Results:

97 PsA patients (N=54 IBP(+), N=43 IBP(-)) received NTK. Both subpopulations were comparable in gender, age and PsA activity at baseline. The treatment led to a pronounced decline in PsA activity in both subpopulations, significant differences between arms were observed only in DAPSA remission and very low disease activity (VLDA) at week 24 (Figure 1A). Changes from baseline in DAS28-CRP were consistent between IBP(+) and IBP(-) patients with a rapid decline during the first month with further improvement up to week 24 (Figure 1B). A similar trend was observed PsA-specific composite responder index (PSARC) (data not shown). A comparable percentage of IBP(+) and IBP(-) patients achieved PSARC at each timepoint of evaluation with 87% and 86% of responders respectively at week 24.

Conclusion:

NTK significantly improved PsA activity regardless of the presence of IBP.

Figure 1.

PsA activity after 24-week treatment with NTK. (A) Percentage of patients with DAPSA remission (0-4), very low disease activity (VLDA), minimal disease activity (MDA) at week 24; (B) change from baseline in DAS28-CRP

Acknowledgements:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Speakers bureau: Abbvie, Biocad, Eli Lilly, Johnson & Johnson, Janssen, Novartis, Pfizer, UCB, Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, V Mazurov: None declared, Aleksey Samtsov: None declared, Vladislav Khayrutdinov: None declared, Andrey Bakulev: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Anna Eremeeva Employee of: Biocad.

AB0540 COMPARISON OF EQ-5D HEALTH STATUS IN PSORIATIC ARTHRITIS PATIENTS WITH OR WITHOUT AXIAL DISEASE: RESULTS OF SUBANALYSIS OF THE PATERA STUDY

Background:

Netakimab (NTK) is an anti-interleukin-17A monoclonal antibody approved for psoriasis, ankylosing spondylitis, psoriatic arthritis (PsA) in Russia and Belarus. PATERA is an ongoing phase 3 international double-blind, placebo-controlled clinical study of NTK in PsA (NCT03598751).

Objectives:

A subanalysis was performed to assess the effect of NTK on domains of the 5-level EuroQol 5 Dimensions questionnaire (EQ-5D-5L) in patients with inflammatory back pain (IBP) (IBP(+)) and without (IBP(-)) at baseline according to self-reported ASAS IBP criteria, 2009.

Methods:

194 adult patients with PsA (CASPAR criteria, 2006) with inadequate response to csDMARD or one TNFi, were randomly assigned to receive NTK 120mg or placebo at weeks 0,1,2,4,6,8,10,14,18,22. The proportion of patients reported >1 problem in each domain was evaluated. Patients with missing values were considered as non-responders in the analysis.

Results:

97 PsA patients (N=54 IBP(+), N=43 IBP(-)) received NTK. The subpopulations didn’t differ significantly in gender, age, and PsA activity at baseline. Comparable percentage of patients reported any problems for each domain at baseline (p≥0.05) (data not shown). IBP(-) subpopulation had a greater improvement for all domains except of anxiety/depression. The absolute declines for IBP(+) vs IBP(-) patients were as followed: 24.1% vs 41.9% (mobility), 18.5 vs 41.9% (self-care), 24.0% vs 51.1% (usual activities), 24.1% vs 37.2% (pain/discomfort), 33.3% vs 9.3% (anxiety/depression). However, the only significant difference between IBP(+) and IBP(-) was observed in usual activity (Figure 1).

Conclusion:

NTK resulted in the growing improvement of each EQ-5D-5L domain through 24 weeks irrespectively of the presence of IBP. IBP(-) subjects showed trend to greater benefit compared to IBP(+).

Figure 1

Percentage of patients reported any problems in (A) pain/discomfort, (B) in usual activity at each visit

Acknowledgements:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Inna Gaydukova Speakers bureau: Abbvie, Biocad, Eli Lilly, MSD, Novartis, Pfizer, Sandoz, Tatiana Korotaeva Speakers bureau: Abbvie, Biocad, Eli Lilly, Johnson & Johnson, Janssen, Novartis, Pfizer, UCB, V Mazurov: None declared., Aleksey Samtsov: None declared., Vladislav Khayrutdinov: None declared., Andrey Bakulev: None declared., Alena Kundzer: None declared., Nikolaj Soroka: None declared., Anna Eremeeva Employee of: Biocad.

AB0792 NETAKIMAB IMPROVES PATIENT-REPORTED OUTCOMES IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM A RANDOMIZED DOUBLE-BLIND PHASE 3 TRIAL (PATERA)

Background:

Psoriatic arthritis (PsA) is associated with multiple manifestations, resulting in reduced health-related quality of life (HR-QoL) of patients (pts). Netakimab (NTK) is a humanized anti-IL17A antibody approved for the treatment of moderate-to-severe plaque psoriasis.

Objectives:

To assess the impact of NTK on patient-reported outcomes (PROs) in active PsA pts, based on data of 24-week (wk) data from the ongoing PATERA study (NCT03598751).

Methods:

PATERA is an international double-blind, placebo-controlled clinical study. 194 eligible adult pts with PsA (CASPAR, 2006), with inadequate response to csDMARD or one TNFi, were randomized (1:1) to receive NTK 120 mg or placebo (PBO) at Wk 0, 1, 2, 4, 6, 8, 10, 14, 18, 22. Pts from PBO arm failed to achieve ACR20 (20% improvement of the American College of Rheumatology criteria) by Wk 16 were switched to NTK. PROs included changes from baseline (BL) in Work Productivity and Activity Impairment General Health (WPAI GH), 36-item Short Form Health Survey (SF-36), European Quality of Life Questionnaire (EQ-5D-5L), Dermatology Quality of Life Index (DLQI), Health assessment questionnaire disability index (HAQ-DI).

Results:

BL demographics and PsA characteristics were similar between treatment arms (Table 1). The proportion of pts with an improvement of ≥1 level in EQ-5D domains at Wk 24 (among pts who reported problems at BL) was higher in NTK arm compared to PBO (Figure 1). The assessment of physical disability showed positive dynamics in NTK arm: at Wk 24 mean change in HAQ-DI from BL was -0.6 for NTK vs -0.1 for PBO (p<0.0001). DLQI was assessed in pts with ≥3% body surface area involvement at BL (N=76 in NTK arm, N=72 in PBO arm). A greater reduction in DLQI was observed in NTK-treated pts (-11.4) compared to PBO-treated pts (-1.8) (p<0.0001). After 24 wks WPAI response for NTK was better than for PBO in all aspects, except work time missed due to PsA (Table 2). Positive dynamics were reported for both SF-36 components, however, the difference between NTK and PBO was not statistically significant. At Wk 24 mean change from baseline in SF-36 PCS in NTK arm was 10.4 vs 7.7 in PBO (p=0.29), mean change in SF-36 MCS was 6.4 vs 9.0 in the same arms, respectively (p=0.56).

Table 1.

BL demographics and PsA characteristics

ArmNTK (N=97)PBO (N=97)Age (years)*44.0 (11.7)43.1 (11.9)Male, n (%)52 (53.6)50 (51.6)PsA duration, mo*63.1 (73.1)68.2 (77.5)HAQ-DI*1.15 (0.6)1.21 (0.6)DLQI*14.8 (6.5)13.9 (7.3)SF36 PCS*32.39 (9.5)31.10 (8.9)SF36 MCS*45.29 (10.7)46.04 (11.5)

* mean (standard deviation), N=number of pts, mo=months, PsA=psoriatic arthritis, HAQ-DI=Health assessment questionnaire disability index, DLQI=Dermatology Quality of Life Index, SF36=36-item Short Form Health Survey, MCS=Mental Component Summary, PCS=Physical Component Summary

Table 2.

WPAI change from BL at wk 24 (mean±standard deviation)

ParameterNTKPBOAbsenteeism (%)-8.7±29.1N=60-9.1±31.8N=47Presenteeism (%)-22.1 ±22.1N=57-1.0±26.5N=42Overall work impairment (%)-18.6±21.8N=570.6±26.7N=42Activity impairment (%)-25.5±25.2N=96-5.4±29.1N=97

N=number of pts in the analysis category

Figure 1.

Improvement in EQ-5D categories

Conclusion:

NTK demonstrated rapid improvement in QoL, work productivity and physical function in pts with PsA.

Acknowledgments:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Consultant of: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Inna Gaydukova Grant/research support from: JSC BIOCAD, Speakers bureau: Pfizer, Novartis, AbbVie, JSC BIOCAD, Сelgene, MSD, Sanofi, V Mazurov: None declared, Aleksey Samtsov Grant/research support from: JSC BIOCAD, Novartis, Eli Lilly, Johnson&Johnson, Celgene, Glenmark, Galderma, Sanofi, Vladislav Khayrutdinov Grant/research support from: Akrikhin, Alkoy, Belupo, JSC BIOCAD, Bosnaliejk, Verteks, Glenmark, Elfa, Leo Pharma, MSD, Novartis, Pfizer, Sun Pharma, Sanofi, Celgene, Pharmtec, AbbVie, Eli Lilly, Jadran, Janssen, Andrey Bakulev Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Muza Kokhan Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Alena Kundzer: None declared, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Ekaterina Dokukina Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD

OP0226 NETAKIMAB DECREASES DISEASE ACTIVITY IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM A RANDOMIZED DOUBLE-BLIND PHASE 3 CLINICAL TRIAL (PATERA)

Background:

Netakimab (NTK) is a humanized anti-interleukin 17A antibody approved for the treatment of moderate-to-severe plaque psoriasis.

Objectives:

To determine the efficacy and safety of NTK in patients (pts) with active psoriatic arthritis (PsA), based on 24-week (Wk) data from an ongoing phase 3 study (NCT03598751, PATERA).

Methods:

194 eligible adult pts with PsA (CASPAR, 2006) with inadequate response to csDMARD or one TNFi, were randomized (1:1) to receive NTK 120 mg or placebo (PBO) subcutaneously at Wk 0, 1, 2, 4, 6, 8, 10, 14, 18, 22. 84 pts from PBO arm who did not meet ACR20 (20% improvement of the American College of Rheumatology criteria) by Wk 16 were switched to NTK 120 mg. The primary endpoint was AСR20 at Wk 24. DAPSA (Disease Activity Index for Psoriatic Arthritis), the proportion of pts achieved ACR50/70, minimal disease activity (MDA) (≥5/7 MDA criteria) and Psoriatic arthritis response criteria (PsARC) were also analyzed.

Results:

Baseline demographics and disease characteristics were similar across treatment arms (Table 1). 80 (82.47%) pts in NTK arm and 9 (9.28%) in the PBO arm achieved ACR20 at Wk 24 (р<0.0001). A significantly greater percentage of NTK-treated pts had ACR50/70, PsARC response, MDA at Wk 24 (Figure 1). By Wk 24 DAPSA significantly improved for NTK vs PBO. DAPSA remission was achieved by 36.08% and 13.40% in NTK and PBO arms, respectively (p=0.003). NTK was well tolerated. The most frequent AEs (≥3%) were lymphopenia, neutropenia, hypercholesterolemia, ALT increased, upper respiratory tract infection, systolic blood pressure increased, hyperglycemia, hyperbilirubinemia. Most AEs were mild to moderate. Severe treatment-related AEs were observed in 1.03% vs 2.06% for NTK and PBO, respectively. No treatment-related SAEs were reported. No anti-drug antibodies were detected.

Table 1.

Baseline demographics and disease severity characteristics

ArmNTK (N=97)PBO (N=97)Age (years) *44.0 (11.66)43.1 (11.88)Male, n (%)52 (53.61)50 (51.55)PsA duration, mo*63.1 (73.12)68.2 (77.49)DAS28-CRP*4.62 (0.97)4.41 (1.11)DAPSA*32.19 (12.23)33.54 (15.98)TJC (66/68) *12.9 (9.97)12.0 (9.88)SJC (66/68) *7.0 (4.93)7.2 (7.18)MTX at baseline83 (85.6)83 (85.6)Previous PsA therapySulfasalazine, n (%)9 (9.28)11 (11.34)Leflunomide, n (%)4 (4.12)8 (8.25)Anti-TNFα, n (%)22 (22.68)17 (17.53)

* mean (standard deviation); Mo=months, PsA=psoriatic arthritis, SJC=swollen joint count, TJC=tender joint count, DAS28=Disease Activity Score, MTX=methotrexate, CRP=C-reactive protein, DAPSA=Disease activity index for psoriatic arthritis, TNF=tumor necrosis factor

Figure 1.

Treatment response at Wk 24

Conclusion:

NTK is a well-tolerated monoclonal antibody, that provided sustained improvements in signs and symptoms of active PsA through 24 Wks of therapy.

Table 2.

Safety data

ArmNTK (N=97)PBO (N=97)p-valueTreatment-related AEs12 (12.37)7 (7.22)0.2271Treatment-related SAEs0 (0)0 (0)1.002Treatment-related AEs (grade 3-4)1 (1.03)2 (2.06)1.002Local reactions0 (0)0 (0)-Grade 3-4 treatment-related AEsblood pressure increased1 (1.03)0(0)1.002lymphopenia0 (0)2 (2.06)0.4972

n (%) are presented,1Pearson’s χ2test,2Fisher’s exact test; N=number of patients, AE=adverse event, SAE=serious adverse event, ALT=Alanine transaminase

Acknowledgments:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Consultant of: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Inna Gaydukova Grant/research support from: JSC BIOCAD, Speakers bureau: Pfizer, Novartis, AbbVie, JSC BIOCAD, Сelgene, MSD, Sanofi, V Mazurov: None declared, Aleksey Samtsov Grant/research support from: JSC BIOCAD, Novartis, Eli Lilly, Johnson&Johnson, Celgene, Glenmark, Galderma, Sanofi, Vladislav Khayrutdinov Grant/research support from: Akrikhin, Alkoy, Belupo, JSC BIOCAD, Bosnaliejk, Verteks, Glenmark, Elfa, Leo Pharma, MSD, Novartis, Pfizer, Sun Pharma, Sanofi, Celgene, Pharmtec, AbbVie, Eli Lilly, Jadran, Janssen, Andrey Bakulev Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Muza Kokhan Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Alena Kundzer: None declared, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Ekaterina Dokukina Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD

FRI0114 EFFICACY OF LEVILIMAB, NOVEL MONOCLONAL ANTI-IL-6 RECEPTOR ANTIBODY, IN COMBINATION WITH METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: 1-YEAR RESULTS OF PHASE 2 AURORA STUDY

Background:

Previously, 12-week results of phase 2 clinical study of levilimab (LVL) in patients with active rheumatoid arthritis (RA) have been reported1. The study has met the primary endpoint at W12 confirming that treatment with LVL 162 mg SC + methotrexate (MTX) either QW or Q2W is superior to MTX alone in patients with RA and inadequate response to methotrexate (MTX-IR). Here we report 1-year efficacy and safety data in QW and Q2W arm of the study.

Objectives:

This study was aimed to assess the efficacy and safety of 2 dosing regimens of LVL in active MTX-IR RA subjects.

Methods:

This multicenter double-blind placebo-controlled study (NCT03455842) enrolled 105 MTX-IR subjects with active RA (ACR2010). The study design is outlined on Figure 1. Secondary endpoints for the open-label period included ACR20/50/70, LDA, remission rates, and DAS28-CRP(4), among others. The safety was evaluated up to W56.

Figure 1.

Study design

Results:

At W12 ACR20 was reached by 77.1% and 57.1% of subjects of QW and Q2W arms respectively. Within open-label (OLE) period further increase in clinical response degree was observed up to W52, more pronounced in ACR50 and even more in ACR70 / RA LDA and Remission rates (Table 1). Figure 1 summarizes the dynamic of DAS28-CRP(4) change throughout the study. QW regimen showed better efficacy results.

Table 1.

Efficacy results (full analysis set), n (%).

QW + MTX(n = 35)Q2W + MTX(n = 35)p-valueACR20 W1227 (77.1)20 (57.1)0.07    W5232 (91.4)25 (71.4)0.03ACR50 W1218 (51.4)11 (31.4)0.09    W5226 (74.3)23 (65.7)0.43ACR70 W1210 (28.6)7 (20.0)0.40    W5223 (65.7)16 (45.7)0.09LDA (DAS28 <3.2) W1220 (57.1)10 (28.6)0.02         W5229 (82.9)24 (68.6)0.16EULAR Remission W244 (11.4)2 (5.7)0.67         W5210 (28.6)10 (28.6)1.00

Table 2 shows the main safety endpoints for the entire study (W0 – W56). The most common treatment related AEs (registered >5% of subjects) were laboratory abnormalities (neutrophil count decrease, ALT / AST increase, blood cholesterol/triglycerides increased). SAE occurred within the blinded study period were reported previously1. During OLE, starting from W12, four new serious AE (SAEs) were reported: 3 in LVL QW arm: haemorrhage (gr.3, unrelated), vaginal cyst (gr.3, unrelated) and keratitis (gr.2, unrelated); 1 in LVL Q2W arm: myocardial ischemia with cardiovascular insufficiency (gr.5, unrelated).

Table 2.

Safety results (full analysis set, W0 – W56), n (%).

QW + MTX(n = 35)Q2W + MTX(n = 35)Any TEAEs/SAEs34 (97.1)29 (82.9)Any SAEs4 (11.4)2 (5.7)Any gr. 3-4 AEs16 (45.7)12 (34.3)Gr. 3-4 neutropenia4 (11.4)5 (14.3)AEs of special interest(ALT / AST high; Leucopenia / Neutropenia; Infections; Cholesterol/triglycerides high)28 (80.0)26 (74.3)Treatment discontinuation due to AE04 (11.3)Deaths02 (5.7) (unrelated)

Conclusion:

Within 1 year of treatment LVL + MTX showed sustained efficacy, with continuous clinical improvement in MTX-IR subjects with active RA. The safety profile of LVL was consistent with other IL6R inhibitors. LVL QW regimen was shown to be safe with better efficacy in terms of time and magnitude and was selected for phase 3 confirmatory clinical study.

References:

[1]http://dx.doi.org/10.1136/annrheumdis-2019-eular.7220

Figure 2.

Absolute DAS-28-CRP(4) change (median ± IQR, full analysis set)

Disclosure of Interests:

V Mazurov: None declared, Evgeniy Zotkin: None declared, Elena Ilivanova Grant/research support from: JSC BIOCAD, Tatyana Kropotina Grant/research support from: JSC BIOCAD, Tatyana Plaksina Grant/research support from: JSC BIOCAD, Olga Nesmeyanova Grant/research support from: JSC BIOCAD, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Alena Kundzer: None declared, Anton Lutskii Employee of: JSC BIOCAD, Ekaterina Dokukina Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD, Arina Zinkina-Orihan Employee of: JSC BIOCAD

FRI0346 EFFICACY OF NETAKIMAB IN THE TREATMENT OF AXIAL DISEASE IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS OF SUBANALYSIS FROM A DOUBLE-BLIND RANDOMIZED PHASE 3 TRIAL (PATERA)

Background:

The presence of axial involvement significantly impacts on psoriatic arthritis (PsA) activity, outcomes and patients (pts) quality of life. IL-17A inhibitors were previously shown to improve axial disease in PsA. Netakimab (NTK) is a humanized anti-interleukin 17A antibody approved for the treatment of moderate-to-severe plaque psoriasis.

Objectives:

To evaluate the effects of NTK on axial symptoms in patients with PsA, based on data of 24-week (wk) observation from an ongoing phase 3 PATERA study (NCT03598751).

Methods:

PATERA is a phase 3 international double-blind, placebo-controlled clinical study. After completion of screening 194 eligible adult patients with PsA fulfilling the CASPAR criteria, with inadequate response to csDMARD or one TNFi, were randomly assigned (1:1) to receive NTK 120 mg or placebo (PBO) at Wks 0, 1, 2, 4, 6, 8, 10, 14, 18 and 22. 84 patients from PBO arm, failed to achieve ACR20 (20% improvement the American College of Rheumatology criteria) by Wk 16, were switched to NTK. A subset of pts with axial involvement (defined by presence of inflammatory back pain (IBP) according to ASAS IBP criteria, 2009) was evaluated with spondylitis-specific assessments: spinal pain (10-item numerical rating scale), nocturnal back pain (10-item numerical rating scale), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score with C-reactive protein.

Results:

104 PsA patients (NTK N=54, PBO N=50) with IBP at baseline (BL) were included in the analysis. Demographic and BL disease characteristics were comparable across the groups (Table 1). During the analyzed period, BASDAI and ASDAS-CRP scores significantly decreased in NTK-treated patients (Figure 1). Maximum decrease in axial disease activity developed by Wk 4-8 depending on index of assessment. The achieved values maintained throughout the entire analyzed period (Table 2). At Wk 24, mean changes in ASDAS-CRP and BASDAI were -1.57 and -2.83 in NTK arm vs -0.11 and -0.19 in PBO arm respectively (p<0.0001).

Table 1.

Baseline demographics and mean composite endpoint scores

ArmNTK (N=54)PBO (N=50)Age (years)*43.5 (12.16)42.7 (10.76)Male, n (%)27 (50)26 (52)PsA duration, mo*70.0 (78.78)79.0 (81.62)BASDAI score*5.58 (1.80)5.79 (1.94)ASDAS-CRP score*3.38 (1.16)3.38 (1.28)nocturnal pain*4.2 (2.42)5.1 (2.29)spinal pain*4.4 (2.41)5.3 (2.40)

* mean (standard deviation) BASDAI=Bath Ankylosing Spondylitis Disease Activity Index, ASDAS-CRP=Ankylosing Spondylitis Disease Activity Score with C-reactive protein

Table 2.

Changes in BASDAI and ASDAS-CRP vs baseline

BASDAIASDAS-CRPNTK (N=54)PBO (N=50)NTK (N=54)PBO (N=50)Wk 4-2.45 (1.94)-0.51 (1.26)-1.44 (1.06)-0.19 (0.60)Wk 8-2.77 (2.22)-0.38 (1.55)-1.53 (1.07)-0.21 (0.74)Wk 16-2.77 (1.83)-0.17 (1.67)-1.52 (0.98)-0.10 (0.97)Wk 24-2.83 (2.15)-0.19 (1.70)-1.57 (1.06)-0.11 (0.95)

mean (standard deviation)

Figure 1.

Mean change in BASDAI, ASDAS-CRP, spinal pain, and nocturnal pain at Wk 24

Conclusion:

About 50% of subjects, randomized to PATERA study, had IBP at baseline. NTK leads to rapid and sustained improvement in axial disease in patients with active PsA.

Acknowledgments:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Inna Gaydukova Grant/research support from: JSC BIOCAD, Speakers bureau: Pfizer, Novartis, AbbVie, JSC BIOCAD, Сelgene, MSD, Sanofi, V Mazurov: None declared, Aleksey Samtsov Grant/research support from: JSC BIOCAD, Novartis, Eli Lilly, Johnson&Johnson, Celgene, Glenmark, Galderma, Sanofi, Vladislav Khayrutdinov Grant/research support from: Akrikhin, Alkoy, Belupo, JSC BIOCAD, Bosnaliejk, Verteks, Glenmark, Elfa, Leo Pharma, MSD, Novartis, Pfizer, Sun Pharma, Sanofi, Celgene, Pharmtec, AbbVie, Eli Lilly, Jadran, Janssen, Andrey Bakulev Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Muza Kokhan Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Alena Kundzer: None declared, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Ekaterina Dokukina Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD

AB0791 NETAKIMAB REDUCES SKIN MANIFESTATIONS OF PSORIATIC ARTHRITIS: RESULTS OF SUBANALYSIS FROM A DOUBLE-BLIND RANDOMIZED PHASE 3 STUDY (PATERA)

Background:

Patients with psoriatic arthritis (PsA) have skin manifestations that negatively affect their quality of life. Netakimab (NTK) is a humanized anti-interleukin 17A antibody approved for the treatment of moderate-to-severe plaque psoriasis.

Objectives:

To evaluate the efficacy of NTK on PsA skin manifestations. This abstract presents 24-week data from the ongoing phase 3 PATERA study (NCT03598751).

Methods:

PATERA is an international, multicenter, double-blind, placebo (PBO)-controlled study. 194 eligible adult patients with psoriatic arthritis (CASPAR, 2006), with inadequate response to csDMARD or one TNFi, were randomly assigned (1:1) to receive NTK 120 mg or placebo (PBO) subcutaneously at Week (Wk) 0, 1, 2, 4, 6, 8, 10, 14, 18, 22. 84 patients from PBO arm, failed to achieve ACR20 (20% improvement in American College of Rheumatology criteria) at Wk 16, were switched to NTK. Endpoints for assessment of skin involvement included PASI the proportion of patients achieving 75%, 90%, and 100% improvement in Psoriasis Area and Severity Index score (PASI75, PASI90 and PASI100, respectively).

Results:

184 patients (NTK arm, N=94; PBO arm, N=90) had PASI>0 at baseline (BL). Demographics and BL characteristics were balanced between treatment arms (Table 1). Treatment response was assessed in patients with ≥3% body surface area involvement (BSA) at BL. PASI75/90/100 response rates for NTK arm were significantly greater than for PBO and increased throughout the whole analyzed period. At Wk 24 PASI75 was achieved by 82.89% vs 11.11% for NTK and PBO, respectively (p<0.0001). A significantly higher percentage of patients achieved complete skin clearance (PASI100) in NTK arm compared to PBO (48.68% vs 6.94%, p<0.0001). PASI90 response rate was also higher for NTK (Figure 1). Relative change (%) from baseline in PASI score correlated with PASI75/90/100 response rates throughout the entire analyzed period. PASI decreased by 87.5 % in NTK arm vs only 4.4% in PBO arm after 24 wks of treatment (Table 2).

Table 1.

BL characteristics (for patients with PASI>0 at BL)

ArmNTK (N=94)PBO (N=90)Age (years)*44.0 (11.82)42.9 (12.14)Male, n (%)51 (54.26)48 (53.33)PsA duration, mo*63.3 (73.81)68.1 (79.79)PASI*12.27 (11.31)10.35 (9.80)

* mean (standard deviation); mo=months, PASI=Psoriasis Area and Severity Index

Table 2.

Percentage (%) change from baseline in PASI total score (mean (SD))

NTK (N=76)PBO (N=72)Week 4*-61.1 (36.04)-8.6 (31.99)Week 8*-74.2 (35.36)-8.4 (37.57)Week 16*-80.8 (49.38)-2.3 (61.06)Week 24*-87.5 (32.83)-4.4 (63.48)

Data are presented for patients with BL BSA ≥ 3%; *p<0.0001 vs placebo

Figure 1.

Percentage of patients with PASI75/90/100 at Wk 24 (in patients with BL BSA≥3)

Conclusion:

24-week treatment with NTK at the dose of 120 mg resulted in significant improvement in skin manifestations in PsA patients: more than half of the patients with BSA≥3 at BL achieved complete skin clearance.

Acknowledgments:

This study was sponsored by JSC BIOCAD.

Disclosure of Interests:

Tatiana Korotaeva Consultant of: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Inna Gaydukova Grant/research support from: JSC BIOCAD, Speakers bureau: Pfizer, Novartis, AbbVie, JSC BIOCAD, Сelgene, MSD, Sanofi, V Mazurov: None declared, Aleksey Samtsov Grant/research support from: JSC BIOCAD, Novartis, Eli Lilly, Johnson&Johnson, Celgene, Glenmark, Galderma, Sanofi, Vladislav Khayrutdinov Grant/research support from: Akrikhin, Alkoy, Belupo, JSC BIOCAD, Bosnaliejk, Verteks, Glenmark, Elfa, Leo Pharma, MSD, Novartis, Pfizer, Sun Pharma, Sanofi, Celgene, Pharmtec, AbbVie, Eli Lilly, Jadran, Janssen, Andrey Bakulev Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Muza Kokhan Grant/research support from: AbbVie, Eli Lilly, Pfizer, UCB, MSD, Novartis, Galderma, Celgene, Leo Pharma and Johnson&Johnson, JSC BIOCAD, Consultant of: Novartis, Celgene and Johnson&Johnson, Speakers bureau: AbbVie, Eli Lilly, Galderma, UCB, Novartis, Celgene and Johnson&Johnson, Alena Kundzer: None declared, Nikolaj Soroka Grant/research support from: JSC BIOCAD, Ekaterina Dokukina Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD

Expanding TREC and KREC Utility in Primary Immunodeficiency Diseases Diagnosis

Primary immunodeficiency diseases (PID) area heterogeneous group of disorders caused by genetic defects of the immune system, which manifest clinically as recurrent infections, autoimmune diseases or malignancies. Early detection of PID remains a challenge, particularly in older children with milder and less specific symptoms. This study aimed to assess TREC and KREC diagnostic ability in PID. Data from children assessed by clinical immunologists at Speransky Children's Hospital, Moscow, Russia with suspected immunodeficiencies were analyzed between May 2013 and August 2016. Peripheral blood samples were sent for TREC/KREC, flow cytometry (CD3, CD4, CD8 and CD19), IgA and IgG analysis. A total of 434 children [189 healthy, 97 with group I and II PID (combined T and B cell immunodeficiencies & well-defined syndromes with immunodeficiency) and 148 group III PID (predominantly antibody deficiencies)] were included. Area under the curve (AUC) for TREC in PID groups I and II diagnosis reached 0.82 (CI = 0.75-0.90), with best model providing sensitivity of 65% and specificity of 92%. Neither TREC, nor KREC had added value in PID group III diagnosis. In this study, the predictive value of TREC and KREC in PID diagnosis was examined. We found that the TREC had some diagnostic utility for groups I and II PID. Possibly, addition of TREC measurements to existing clinical diagnostic algorithms may improve their predictive value. Further investigations on a larger cohort are needed to evaluate TREC/KREC abilities to be used as diagnostic tools on a wider scale.