Secukinumab Improves Signs and Symptoms of Axial Spondyloarthritis

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An analysis of patients with active non-radiographic axial spondyloarthritis (nr-axSpA) with an elevated C-reactive protein (CRP) and/or evidence of sacroiliitis on magnetic resonance imaging (MRI) found that secukinumab (Cosentyx, Novartis) use resulted in numerically higher treatment response rates than placebo.

The results of this study will be presented by Jorgen Braun, M.D., of Ruhr-University Bochum in Germany, during the annual meeting of the American College of Rheumatology annual meeting on Sunday.

Secukinumab, which is approved for use in nr-axSpA, was previously shown to improve signs and symptoms in patients with nr-axSpA in the phase 3 PREVENT study, which was published in Arthritis & Rheumatology in August.

This exploratory analysis looked at the efficacy of secukinumab using data from the PREVENT study stratified by CRP and MRI status at study entry. A total of 555 nr-axSpA patients, placed in CRP and/or MRI positive subgroups, were randomly assigned to subcutaneous secukinumab 150 mg, with or without loading, or placebo every four weeks.

Efficacy assessments by CRP and MRI status includedAssessment in SpondyloArthritis international Society 40 percent (ASAS40), Bath Ankylosing Spondylitis Disease Activity Index 50 percent (BASDAI50), ASAS-partial remission, and ASDAS-CRP inactive disease responses at 16 weeks.

Compared with placebo, numerically higher response rates for secukinumab were seen for all endpoints, with most notable differences observed for ASAS-partial remission and ASDAS-CRP inactive disease responses.

“The PREVENT study showed that secukinumab 150mg provided significant improvement in signs and symptoms, disease activity, physical function, quality of life, and objective signs of inflammation in patients with nr-axSpA,” the authors wrote in their study. “The results of the pre-planned exploratory analysis across CRP and MRI status (positive and/or negative) showed that secukinumab improved signs and symptoms across CRP and/or MRI positive subgroups, with the highest treatment responses observed in the CRP+/MRI+ subgroup.”

“The results of the PREVENT study, combined with the results from the MEASURE studies in ankylosing spondylitis, demonstrate that secukinumab is an effective treatment for patients across the spectrum of axial SpA from nr-axSpA to ankylosing spondylitis,” the authors wrote.

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REFERENCE

ABSTRACT: 1366.Inflammation. “Secukinumab Improved Signs and Symptoms in Patients with Non-radiographic Axial Spondyloarthritis: Results from a Randomized Controlled Phase III Study Stratified by Baseline Objective Signs of Inflammation.” The annual meeting of the American College of Rheumatology. 11:00 AM, Sunday, Nov. 8, 2020.

Atul Deodhar, Ricardo Blanco Eva, Dokoupilová Deodhar, et al. “Secukinumab improves signs and symptoms of non‐radiographic axial spondyloarthritis: primary results of a randomized controlled phase III study.” Arthritis & Rheumatology. Aug. 7, 2010. doi:10.1002/art.41477