Novartis (VTX: NOVN) plans to initiate the head-to-head proof of concept ARROW study, assessing the mechanistic superiority of the direct inhibition of IL-17A with Cosentyx (secukinumab) over the inhibition of IL-23 with Tremfya (guselkumab) in patients with psoriatic plaques resistant to treatment with Stelara, the multinational pharmaceutical company announced on Tuesday.

The objective of the ARROW study is to assess the mechanistic superiority of Cosentyx over Tremfya in controlling clinical activity in psoriatic plaques resistant to treatment with Stelara.

Cosentyx is the first fully-human biologic that specifically inhibits interleukin-17A (IL-17A), a cornerstone cytokine that is involved in the inflammation and development of psoriasis, ankylosing spondylitis (AS), and psoriatic arthritis (PsA). IL-17A is produced by both IL-23 dependent and IL-23 independent pathways, by various cells from both the innate immune system, which can be triggered by mechanical stress, and the adaptive immune system. Cosentyx is able to inhibit the cornerstone cytokine regardless of where the IL-17A comes from.

ARROW is a global, multi-centre, open-label, randomised proof of concept Phase 2a study that will involve 40 patients who will receive either secukinumab 300mg or guselkumab 100mg.

Results from the study are expected in 2019.