Being a primary not responding to biologics (psoriatic arthritis patient) is it better to start a brand new treatment with Secukinumab or with Apremilast?
Carissima Catina,
credo secukinumab rappresenti una attuale buona scelta; sto raccogliendo ottime risposte cliniche in diversi pazienti che non avevavo risposto a tutti gli antiTNF. Apremilast non è ancora prescrivibile e non posso darti riscontri clinici.
Un caro abbraccio, Angelo
I've seen both work (my patients) but there are no head-to-head trials. I would use secukinumab if the arthritis were severe, aprimelast if less so. This is after TNF right?
Many thanks to your answer. I've been trying all TNF and responding to none of them since 2010. Last year I try a cure with Ustekinumab and it did not work at all.
I've never used UST for PsA but am pretty sure it does not work well at arthritis. It seems to work better than TNFs for skin, and vice-versa. Good luck.
secukinumab is more effective in PsA than Apremilast especially when talking about highly active cases DAPSA > 28
Best regards, Wesam
Apremilast in my opinion would be indicated for more moderate patients. Those oligoarticular, polyarticular patients with low inflammatory activity or those with manifestations of entheses or dactylitis.
I prefer Apremilast at all, especially I have been working with outpatients.
Miljenko Cvjetičanin, MD, P.hD. PM&R Specialist from Zagreb, Croatia
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