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Mirikizumab Beats Placebo, Secukinumab for Psoriasis

The investigational monoclonal antibody mirikizumab performed more robustly against placebo overall — and the interleukin (IL)-17 inhibitor secukinumab at key endpoints — for treatment of moderate-to-severe psoriasis, according to new long-term OASIS-2 trial data.  

Both doses of mirikizumab in the international, double-blind trial achieved improvements in Psoriasis Area and Severity Index (PASI) scores in larger numbers of participants at week 52 than secukinumab (Cosentyx), with low adverse event rates.

If approved, mirikizumab, which binds the p19 subunit of IL-23, would join three other IL-23 drugs already marketed in the United States for moderate-to-severe psoriasis, said OASIS-2 lead investigator Kim Papp, MD, PhD, from Probity Medical Research in Waterloo, Canada.



Dr Kim Papp

But Papp feels larger studies “will be necessary to put these data into perspective,” he said during a presentation at the 29th European Academy of Dermatology and Venereology (EADV) Congress, held virtually this year because of the pandemic.

“Probably the most important takeaway here is that we may have another option to choose from,” Papp told Medscape Medical News. “People tend to think we have an adequate stable of treatment options, and I would argue we do not.”

“There are variations over time that occur in terms of an individual’s biological response, and the consequence is that nothing we have works for everyone, and nothing we have works forever,” he added.

Psoriasis biologics “are increasingly competent compared to medications we had even 5 or 10 years ago…but they still don’t satisfy all our needs, so we do need to keep replenishing our stock.”

The multicenter trial included 1465 patients who were randomly split into four groups. Subcutaneously, one group received 250 mg of mirikizumab every 4 weeks, and then 250 mg of the drug every 8 weeks starting at week 16. Another group received 250 mg of mirikizumab every 4 weeks and then 125 mg every 8 weeks starting at week 16.

The third group received 300 mg of secukinumab weekly for 4 weeks and then every 4 weeks starting at week 4. The last group received placebo every 4 weeks, and then 250 mg of mirikizumab every 4 weeks from week 16 to 32 and every 8 weeks thereafter.

Primary endpoints measured the percentage of patients achieving a static Physician’s Global Assessment (sPGA) of 0 or 1, with an improvement of at least 2 points from baseline; and the proportion of patients with PASI 90 at week 16 compared with placebo.

Major secondary endpoints were PASI 75 and PASI 100 compared with placebo at week 16; an sPGA of 0 or 1 and PASI 90 non-inferiority compared with secukinumab at week 16; and sPGA of 0 or 1, PASI 90, and PASI 100 superiority compared with secukinumab at week 52.

More than 91% of participants completed all 52 weeks in the trial. Mirikizumab met primary endpoints compared with placebo and major secondary endpoints vs secukinumab at week 16 (P < .001). PASI 90 and sPGA (0,1) response rates far exceeded placebo for both 250 mg

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fitness

Apple Watch Series 6 Beats Garmin’s Fenix 6 Pro For Fitness Tracking In One Important Way

A Garmin runner’s watch like the Fenix 6 Pro Solar is an obvious choice if you want a wearable to track runs, walks and bike rides. But does it really do the job better than an Apple Watch Series 6?

I decided to test these watches’ heart rate sensors in the context of a run. An Apple Watch on one wrist, a Garmin Fenix 6 Pro Solar on the other, and a Wahoo Tickr HR strap around the chest, acting as a control for this not-quite-scientific test.

Here are the results over a roughly 7km run, one dotted with breaks and slow-downs to see how the trackers cope with sharp changes in effort. The Garmin is the red line, the Apple Watch Series 6 the blue line and the Wahoo Tickr the green.

The most obvious fault here is the Wahoo Tickr chest strap’s. Or, to be fair, my own. Its readings are all patchy and intermittent at the first increase in pace, most likely because the strap wasn’t quite tight enough to start.

However, it is otherwise the most accurate of the three. And I’ve left the first few minutes of tracking in this graph to highlight the main wearable takeaway.

The Apple Watch Series 6 starts off from a much better position than the Garmin Fenix 6 Pro, whose results are too high. This is a common observation of Garmins and wearables in general: their HR tracking algorithms tend to assume your heart rate will be far above your resting rate as soon as you begin tracking an exercise.

If you start the session as you warm-up, it will not be. The Apple Watch Series 6’s readings are very accurate from the first seconds onwards.

This issue with lower heart rate readings continues throughout the run. In each decrease in pace, or outright stop in the case of the deepest dip in the graph, the Apple Watch Series 6 tightly matches the lowest reading recorded by the Wahoo Tickr chest strap. But the Garmin’s are all routinely slightly higher.

MORE FROM FORBESGarmin Fenix 6 Pro Solar: Check Out Its 48 Exercise Modes And Fitness Features

The Garmin Fenix 6 Pro shows significantly higher readings during the cool-down too, aside from an aberrant blip at the end where the recorded rate drops, and then compensates with an artificially high peak.

Apple’s Watch Series 6 only failed to keep up, slightly, with the Tickr when I went from running to sitting on a bench, to cause a very steep fall in heart rate. The Apple and Garmin’s falls are similarly cliff-like, but not as steep as the Tickr’s.

The Apple Watch Series 6’s heart rate hardware is superb, obviating the need for a chest strap, for most people. There is another side to this story, though.

To

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dentist

Local lawyer beats doctor, dentist in big East Geelong auction sale

East Geelong has again proved a beacon for professionals with a doctor, lawyer and dentist contesting the auction of a renovated character home that sold for $90,000 above reserve.

The local lawyer outlasted the competition to buy the four-bedroom house at 1 Darling Street for $892,000.

It’s the highest price ever recorded in the street, eclipsing the previous top sale by $40,000, CoreLogic records show.

RELATED: Four bids seal South Geelong sale

Belmont house smashes reserve by $90K

Locals grab Geelong heritage renovation

McGrath, Geelong agent David Cortous said bidding moved quickly past the $800,000 reserve price at Saturday’s auction.

He said the trio of bidders were all attracted to the low-maintenance lifestyle on offer.

“There was a doctor, a lawyer and a dentist, you could not have written a better script and the local lawyer bought it,” Mr Cortous said.

“The house was basically rebuilt eight years ago and it was just beautifully presented, well-built home with nothing to do.”

A rear open-plan living zone was the centrepiece of the renovation and includes a quality kitchen with Caesarstone benchtops and European appliances.

It provides easy access to a covered deck and compact landscaped backyard.

Mr Cortous said the confident bidding was a great sign for real estate in Geelong.

“There is certainly plenty of depth in the market, even without the Melbourne buyers,” he said.

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