Comparative effectiveness of secukinumab and etanercept in biologic-naïve patients with psoriatic arthritis assessed by matching-adjusted indirect comparison

Objectives
Matching-adjusted indirect comparison (MAIC) can be used to assess the comparative effectiveness of two treatments indirectly using data from randomized placebo-controlled trials. This MAIC assessed the comparative effectiveness of secukinumab (an anti-interleukin-17A) and etanercept (a tumor necrosis factor inhibitor [TNFi]) in a target population of biologic-naïve patients with psoriatic arthritis (PsA).
Methods
Individual patient data pooled from FUTURE 2 (NCT01752634), FUTURE 3 (NCT01989468), and FUTURE 5 (NCT02404350) (secukinumab: 150 mg, n=458; 300 mg, n=461) were matched to data from the population in the NCT00317499 trial (etanercept 25 mg, n=101) using MAIC methodology, by adjusting for clinical and demographic baseline characteristics. Recalculated outcomes from FUTURE 2, 3, and 5 (150 mg, effective sample size [ESS] post-matching=104; 300 mg, ESS=75; placebo, ESS=159) were compared with the NCT00317499 trial. Pairwise comparisons using odds ratios (ORs) were performed for American College of Rheumatology (ACR) 20, 50, and 70 response criteria at week 12 (placebo-adjusted) and week 24 (non-placebo-adjusted). 
Results
At week 12, there were no significant differences in ACR responses between secukinumab and etanercept. There was no significant difference between secukinumab 150 mg and etanercept at week 24 in terms of ACR 20 and 50 response rates; however, ACR 70 response rates were higher for secukinumab 150 mg (odds ratio [OR] [95% confidence interval]: 4.48 [2.01–9.99], p<0.001). Higher ACR 20, 50, and 70 response rates were observed with secukinumab 300 mg when compared with etanercept at this time point (OR [95% confidence interval]: ACR 20, 3.28 [1.69–6.38], p<0.001; ACR 50, 1.90 [1.04–3.50], p=0.038; ACR 70, 3.56 [1.51–8.40], p=0.004).
Conclusions
In this MAIC, secukinumab was associated with higher ACR 20 and 50 (secukinumab 300 mg), and 70 (secukinumab 150 mg and 300 mg) response rates at week 24 than etanercept in biologic-naïve patients with active PsA, whereas no significant difference was observed in the short term at week 12.