Matching-Adjusted Indirect Comparison of Secukinumab, Adalimumab in AS

WASHINGTON DC — Results from a matching-adjusted indirect comparison of three different clinical trials comparing secukinumab and adalimumab showed greater Ankylosing Spondylitis Disease Activity Score (ASAS) 20 and 40 response rates at multiple follow-up periods in patients taking secukinumab compared with patients taking adalimumab, according to recent research at the American College of Rheumatology Annual Meeting in Washington, D.C.

Walter P Maksymowych, MD, from the University of Alberta, in Edmonton, AL, Canada, and colleagues used individual patient data to weigh the baseline characteristics of 125 patients taking 150 mg of secukinumab (SEC) in the MEASURE 1 study (ClinicalTrials.gov Identifier: NCT01358175), 72 patients in the MEASURE 2 study (ClinicalTrials.gov Identifier: NCT01649375)and 208 patients taking 40 mg of adalimumab (ADA) in the ATLAS study (ClinicalTrials.gov Identifier: NCT00085644), according to the abstract. They used logistic regression to weigh factors such as previous anti-tumor necrosis factor therapy, Bath Ankylosing Spondylitis Functional Index (BASFI), C-reactive protein, age, and gender.

After recalculating outcomes in the group of patients receiving SEC 150 mg, researchers created an effective sample size of 120 patients for the SEC group and 120 patients for the placebo group, and compared them with ADA results at 12 weeks, 16 weeks, 24 weeks and 52 weeks, with placebo comparison results available until 12 weeks.

The researchers found no difference between placebo-adjusted response rates in either the SEC or ADA groups at 12 weeks; however, non-placebo adjusted ASAS 20 response rates were higher for the SEC group compared with the ADA group (odds ratio [OR] = 1.60; 95% confidence interval [CI], 1.01 – 2.54; P = .047), according to the abstract. 

Compared with the ADA group, the SEC group had higher non-placebo adjusted response rate ASAS 20 (OR = 1.76; 95% CI, 1.11 – 2.79; P = .017) and ASAS 40 response rates (OR = 1.79; 95% CI, 1.14 – 2.82; P = .012) at 24 weeks. At 52 weeks, the SEC group also had higher non-placebo adjusted ASAS 20 (OR = 1.48; 95% CI, 0.98 – 2.22; P = .062) and ASAS 40 (OR = 1.54; 95% CI, 1.06 – 2.23; P = .023) response rates compared with the ADA group.

“This MAIC showed that SEC 150 mg was associated with higher (non-placebo-adjusted) ASAS 20 response rates at weeks 16, 24 and 52 and ASAS 40 at weeks 24 and 52 relative to ADA,” Dr Maksymowych and colleagues stated.

“No differences in placebo-adjusted response rates were evident at week 12. Substantial switching of placebo patients to active therapy in ATLAS precluded analysis of placebo-adjusted data beyond week 12. This exploratory analysis requires confirmation by a head-to-head [randomized controlled trial].”

Disclosures

Dr Maksymowych received research grants from Abbvie, Pfizer, and Sanofi; and is a paid consultant for Abbvie, Amgen, Boehringer, Eli-Lilly, Janssen, Merck, Pfizer, Sanofi, and UCB. Strand is a paid consultant for Abbvie, Amgen, AstraZeneca, BiogenIdec, Boehringer Ingelheim, Celltrion, Crescendo, Genentech/Roche, GSK, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Samsung, Sanofi, and UCB. 

Dr Nash receives research grants from, is a paid consultant for and is on the speaker’s bureau for Novartis Pharma AG. 

Dr Thom is a paid consultant for Novartis Pharma AG and F. Hoffmann-La Roche AG. 

Dr Karabis is a paid employee of Mapi Group, and is a paid consultant for Novartis Pharma AG. 

Drs Gandhi and Porter receive stock or stock options from and are paid employees for Novartis Pharmaceuticals Corporation. 

Dr Jugl is a shareholder of Novartis Pharma AG and a full-time employee of Novartis Pharma AG.

Reference

Maksymowych WP, Strand V, Nash P, et al. Comparative effectiveness of Secukinumab and Adalimumab in Ankylosing Spondylitis As Assessed By Matching-Adjusted Indirect Comparison: An Analysis Based on All Pivotal Phase 3 Clinical Trial Data. Presented at: ACR/ARHP Annual Meeting; November 11-16, 2016; Washington D.C. Abstract #1739.