03423nam a2200361   4500001000800000005001700008007000300025008004100028040000800069041000800077100003400085245005900119300002300178520229400201650001802495650002602513650003302539650003102572650002202603650002602625650002302651650002202674700003102696700002602727700003402753700002902787700002802816700003102844700002802875773011002903942003103013999001703044ESSALUD20260817155615.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aspa  aStone, John H. eAutor954096  aPhase 3 trial of secukinumab in polymyalgia rheumatica  apáginas: 637-647  aBackground: Polymyalgia rheumatica is a common inflammatory disease characterized by pain and stiffness in the shoulders and hips. Glucocorticoids are the first-line treatment, but relapses and glucocorticoid-related toxic effects are common, which underscores the need for effective alternatives. Secukinumab is a fully human monoclonal antibody that selectively inhibits interleukin-17A. Methods: We enrolled patients with recently relapsed polymyalgia rheumatica and randomly assigned them, in a 1:1:1 ratio, to receive secukinumab at a dose of 300 mg (SEC-300 group), secukinumab at a dose of 150 mg (SEC-150 group), or placebo for 52 weeks. Patients in all the groups also received prednisone on a tapering schedule for 24 weeks. The primary outcome was sustained remission at week 52, defined as remission (the absence of signs or symptoms attributable to polymyalgia rheumatica and no new diagnosis of giant-cell arteritis that warranted escape or rescue treatment) that was sustained from week 12 until week 52. The annual cumulative glucocorticoid dose was a secondary outcome. Safety was also assessed. Results: A total of 381 patients underwent randomization, and 127 were assigned to each group. At 52 weeks, sustained remission was observed in 41.2% (95% confidence interval [CI], 32.8 to 49.7) of the patients in the SEC-300 group, in 40.6% (95% CI, 32.2 to 49.0) of those in the SEC-150 group, and in 20.4% (95% CI, 13.6 to 27.2) of those in the placebo group (P<0.001 for the comparison of each secukinumab dose with placebo). The mean adjusted annual cumulative glucocorticoid dose was 1603.7 mg in the SEC-300 group, 1683.2 mg in the SEC-150 group, and 2093.0 mg in the placebo group. Serious adverse events occurred in 13.5% of the patients in the SEC-300 group, in 15.9% in the SEC-150 group, and in 14.2% in the placebo group. Nasopharyngitis, hypersensitivity reactions, urinary tract infections, fungal infections, and back pain were more common in the secukinumab groups than in the placebo group. Conclusions: Among patients with relapsed polymyalgia rheumatica, treatment with secukinumab plus a 24-week glucocorticoid taper resulted in a higher percentage of patients with remission and in lower cumulative glucocorticoid doses than a glucocorticoid taper alone.  aALERGIA97055  aINMUNOLOGÍA 934121  aENFERMEDAD AUTOINMUNE953665  aMEDICINA CLÍNICA 933681  aGERIATRÍA91852  aREUMATOLOGÍA 97490  aCÉLULAS T954097  aVASCULITIS932232  aButtgereit, Frank  954098  aSaraux, Alain 954099  aSchmidt, Wolfgang A.  954100  aDejaco, Christian954101  aSpiera, Robert  954102  aDasgupta, Bhaskar  954103  aDrescher, Edit  9541040 022717922647dMassachusetts NEJM GroupoNEJM010tThe New England Journal of Medicine wESSALUDx0028-4793  cARTICULOSe2026-08-17zSQB  c22824d22824