Secukinumab Improves Clinical Outcomes, Reduces NSAID Intake Among Patients With Ankylosing Spondylitis

Among patients with ankylosing spondylitis (AS), treatment with secukinumab may improve clinical outcomes while reducing intake of nonsteroidal anti-inflammatory drugs (NSAIDs), according to study results presented at the American College of Rheumatology (ACR) Convergence 2021, held virtually from November 3 to 10, 2021.

Although NSAIDs may be used to alleviate symptoms of AS, the potential adverse effects associated with these medications support the use of lower doses and dose reduction.

The current study was aimed at assessing the short-term NSAID-sparing effect of secukinumab among patients with AS.

The prospective controlled trial included 211 patients with active AS and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4. All patients had an inadequate response to at least 2 NSAIDs and received at least 50% of the highest recommended/tolerated NSAID dose regularly.

The primary study outcome was response to treatment according to the Assessment in Ankylosing Spondylitis (ASAS) score at 12 weeks.

Participants (mean age, 45.2±12.3 years; 57.8% men) were randomly assigned to receive secukinumab 150 mg from week 0 (group 1; n=71), week 4 (group 2; n=70), and week 16 (group 3; n=70). Baseline characteristics, ASAS-NSAID score, BASDAI, and Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP scores were similar between groups.

At week 12, ASAS20 response to treatment was 51.1% in groups 1 and 2 compared with 44.3% in group 3; however, the primary endpoint was not met (P =.35). At week 16, ASAS20 response rates were 56.3% in group 1, 50.0% in group 2, and 41.4% in group 3, with ASAS40 response rates of 43.7%, 32.9%, and 21.4%, respectively. Response rates at 16 weeks according to BASDAI50 were higher for patients in groups 1 and 2 compared with group 3 (32.4%, 28.6%, and 22.9%, respectively).

Intake of NSAIDs was determined using the ASAS-NSAID score, with at least a 50% decrease after 16 weeks noted in 64.8%, 58.6%, and 42.9% of patients from group 1, group 2, and group 3, respectively.

“In this population of patients with AS, secukinumab provided clinical improvements in conventional clinical outcomes and a short-term NSAID sparing effect,” the researchers concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 

Reference

Kiltz U, Baraliakos, X, Brandt-Jrgens J, et al. Evaluation of the nonsteroidal anti-inflammatory drug-sparing effect of secukinumab in patients with ankylosing spondylitis: multicenter, randomized, double-blind, phase IV study. Presented at: ACR Convergence 2021; November 3-10, 2021. Abstract 0908.