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UK MHRA expands Cosentyx® (secukinumab) licence for use in paediatric arthritic conditions

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UK MHRA expands Cosentyx® (secukinumab) licence for use in paediatric arthritic conditions

UK MHRA expands Cosentyx® (secukinumab) licence for use in paediatric arthritic conditions

London, November 7, 2022 — Novartis today announced that the UK Medicines & Healthcare products Regulatory Agency (MHRA) has granted marketing authorisation for Cosentyx® (secukinumab), alone or in combination with methotrexate (MTX), in two types of juvenile idiopathic arthritis (JIA), enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA), in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy1.

JIA is the most common type of arthritis in under 16s, affecting about 1 in 1,000 with approximately 1,500 diagnosed in the UK every year3,4. ERA and JPsA are forms of JIA and are progressive, debilitating autoimmune diseases, each accounting for up to 11% of all JIA cases3-6. If left untreated, they can lead to high levels of pain, joint swelling and disability, with many young people continuing to have active disease well into adulthood4-7. But if properly managed, it’s possible for patients to live with inactive disease and prevent the progression of rheumatoid arthritis, including hand, limb and spine deformities4.

“We are pleased to announce the news of marketing authorisation for secukinumab in young people living with ERA and JpsA and are delighted that they will now have the possibility of accessing an additional treatment option,” said Marie-Andrée Gamache, Country President, Novartis Innovative Medicines UK and Ireland. “At Novartis, we are continuing in our aspiration to eliminate the disease burden for every person living with painful and debilitating long-term immunological conditions by leading in the commercial sponsorship of clinical trials and turbo-charging discovery with investments in data and digital technologies.” 

This approval is based on results from the Phase III JUNIPERA trial, which showed significantly longer time to flare for both JPsA and ERA patients who were treated with secukinumab compared with those given the placebo2. The risk of flare was reduced by 72% for patients on secukinumab for 2 years compared with patients on placebo2. Additionally, more patients achieved and maintained JIA American College of Rheumatology (ACR) score 30, 50, 70, 90 and 100 with secukinumab compared with placebo at 2 years1.

“If left untreated, both ERA and JPsA can lead to high levels of pain and long-term disability. Evidence shows secukinumab reduces flare risk and joint symptoms in young people affected by JPsA and ERA for a sustained period up to 2 years. This authorisation provides us with an alternative targeted therapy, offering patients the potential for a monthly dosing option,” said Professor Athimalaipet Ramanan, consultant paediatric rheumatologist at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW).

Safety in this paediatric population was consistent with the known safety profile of secukinumab for the treatment of adult and paediatric plaque psoriasis, PsA and axial spondyloarthritis8. An extension study of secukinumab evaluating the long-term efficacy, safety and tolerability up to 4 years in patients with ERA and JPsA is currently ongoing9.

About the JUNIPERA trial

The Phase III JUNIPERA trial is a 2-year, three-part, double-blind, placebo-controlled, randomised withdrawal trial that enrolled 86 children and adolescents aged 2–18 years old with a confirmed diagnosis of ERA or JPsA according to the modified International League of Associations for Rheumatology classification criteria10. The trial met its primary endpoint and demonstrated a statistically significant longer time to disease flare in treatment period 2 for ERA and JPsA with secukinumab versus placebo. A total of 21 patients in the placebo group experienced a flare (11 JPsA and 10 ERA) compared with 10 patients in the secukinumab group (4 JPsA and 6 ERA) during the placebo-controlled treatment period 2 of the trial2. Safety in this paediatric population was consistent with the known safety profile of secukinumab for the treatment of adult and paediatric plaque psoriasis, PsA and axial spondyloarthritis2.

About Cosentyx

Cosentyx is the first and only fully human biologic that directly inhibits interleukin-17A, an important cytokine involved in the inflammation of PsA, moderate to severe plaque psoriasis, paediatric plaque psoriasis, paediatric ERA, JPsA, ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)11,12. Cosentyx is a proven medicine and has been studied clinically for more than 14 years. The medicine is backed by robust evidence, including 5 years of clinical data in adults supporting long-term safety and efficacy in adult patients with moderate to severe plaque psoriasis, PsA, AS and nr-axSpA13-19. These data strengthen the position of Cosentyx as a treatment option in these conditions, and are supported by more than 875,000 patients treated worldwide since launch in 201512, 20, 21.

About Novartis

Novartis is reimagining medicine to improve and extend people’s lives. As a leading global medicines company, we strive to use innovative science and digital technologies to create treatments in areas of great medical need. In our quest to find new medicines, we consistently rank among the world’s top companies investing in research and development. Novartis products reach more than 800 million people globally and we are finding innovative ways to expand access to our latest treatments. About 108,000 people of more than 140 nationalities work at Novartis around the world.

In the UK, we employ approximately 1,500 people to serve healthcare needs across the whole of the UK, as well as supporting the global operations of Novartis. Since 2014, Novartis has invested over £200 million in R&D and is a leading sponsor of clinical trials in the UK. For more information, please visit www.novartis.co.uk.

Novartis UK is on Twitter. Sign up to follow @NovartisUK at www.twitter.com/novartisuk

References

  1. Cosentyx Summary of Product Characteristics. 2022.
  2. Brunner HI, Foeldvari I, Alexeeva E, et al. Secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 trial. Ann Rheum Dis. 2022.
  3. How common is JIA? The National Rheumatoid Arthritis Society (NRAS). Available from: https://jia.org.uk/resource/what-is-jia/ [Last accessed: November 2022].
  4. Momah T and Ray L. Juvenile idiopathic arthritis: Old disease, new tactics. J Fam Pract. 2019;68:E8-E13.
  5. American College of Rheumatology. Juvenile Arthritis [online] March 2019. Available from: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Juvenile-Arthritis [Last accessed: November 2022].
  6. Weiss PF, Beukelman T, Schanberg LE, et al. Enthesitis-related arthritis is associated with higher pain intensity and poorer health status in comparison with other categories of juvenile idiopathic arthritis: the Childhood Arthritis and Rheumatology Research Alliance Registry. J Rheumatol. 2012;39:2341-51.
  7. Glerup M, Rypdal V, Arnstad ED, et al. Long-Term Outcomes in Juvenile Idiopathic Arthritis: Eighteen Years of Follow-Up in the Population-Based Nordic Juvenile Idiopathic Arthritis Cohort. Arthritis Care Res (Hoboken). 2020;72:507-516.
  8. Ruperto N, Foeldvari I, Alexeeva E, et al. Efficacy and Safety of Secukinumab in Enthesitis-related Arthritis and Juvenile Psoriatic Arthritis: Primary Results from a Randomised, Double-blind, Placebo-controlled, Treatment Withdrawal, Phase 3 Study (JUNIPERA). Presented as a late-breaking abstract at European Alliance of Associations For Rheumatology (EULAR) Virtual Congress; June 2-5, 2021. Abstract LB0004.
  9. ClinicalTrials.gov. An Extension Study of Subcutaneous Secukinumab in Patients With Juvenile Psoriatic Arthritis (JPsA) and Enthesitis Related Arthritis (ERA). Available from: https://clinicaltrials.gov/ct2/show/NCT03769168. [Last accessed: November 2022]
  10. Clinical Trials.gov. Secukinumab Safety and Efficacy in Juvenile Psoriatic Arthritis (JPsA) and Enthesitis-related Arthritis (ERA). Available from: https://clinicaltrials.gov/ct2/show/NCT03031782. [Last accessed: November 2022].
  11. Girolomoni G, Mrowietz U and Paul C. Psoriasis: rationale for targeting interleukin-17. Br J Dermatol. 2012;167:717-24.
  12. Novartis Europharm Limited. Cosentyx® (secukinumab): Summary of Product Characteristics. Available from: https://www.ema.europa.eu/en/documents/product-information/cosentyx-epar-product-information_en.pdf [Last accessed: November 2022].
  13. Baraliakos X, Braun J, Deodhar A, et al. Long-term efficacy and safety of secukinumab 150 mg in ankylosing spondylitis: 5-year results from the phase III MEASURE 1 extension study. RMD Open. 2019;5:e001005.
  14. Bissonnette R, Luger T, Thaçi D, et al. Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study). J Eur Acad Dermatol Venereol. 2018;32:1507-1514.
  15. Mease PJ, Kavanaugh A, Reimold A, et al. Secukinumab Provides Sustained Improvements in the Signs and Symptoms of Psoriatic Arthritis: Final 5-year Results from the Phase 3 FUTURE 1 Study. ACR Open Rheumatol. 2020;2:18-25.
  16. McInnes IB, Behrens F, Mease PJ, et al. Secukinumab versus adalimumab for treatment of active psoriatic arthritis (EXCEED): a double-blind, parallel-group, randomised, active-controlled, phase 3b trial. Lancet. 2020;395:1496-1505.
  17. Data on file. CAIN457F2310 (MEASURE 1 and 2): Pooled Safety Data. Novartis Pharmaceuticals Corp; July 23, 2018.
  18. Data on file. CAIN457F2310 and CAIN457F2305 summary of 5-year clinical safety in (ankylosing spondylitis). Novartis Pharmaceuticals Corp; May 2019.
  19. Data on file. CAIN457F2312 Data Analysis Report. Novartis Pharmaceuticals Corp; November 2008.
  20. Data on file. AIN457A2102 Clinical Study Report. Novartis Pharmaceuticals Corp; December 2008.
  21. Data on file. COSENTYX Access. Novartis Pharmaceuticals Corp; October 2022.

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