What's New in AS Treatment? Beyond Anti-TNF Therapy

Managing AS patients who have failed anti-TNF therapy or who have a contraindication can be a huge challenge. There were several posters today reporting on secukimumab, an anti-interleukin-17A monoclonal antibody, which seems to be a promising alternative.

Dr. Dominique Baeten and colleagues from Amsterdam reported the long-term efficacy and safety of secukinumab from the 104-week extension of the MEASURE 1 study (poster #2896). 371 patients with active AS were randomized to secukinumab or placebo. Patients received an IV loading dose at weeks 0, 2 and 4, then SC dosing every 4 weeks. There was crossover at weeks 16 and 24 for placebo nonresponders.

Results showed sustained efficacy in all endpoints out to 104 weeks. ASAS20/40 response rates were approximately 80% and 64% at 104 weeks, respectively. Radiographic progression as measured by MSASS was 0.3 units. The rate of serious adverse events (SAEs) was very low.

Another poster (#2890) by the same group evaluated the efficacy and safety of secukinumab by anti-TNF history in the MEASURE 1 and 2 trials. The 150 mg SC dose showed improved signs and symptoms in both TNF-naïve and TNF-IR (inadequate response) groups. Not surprisingly, responses in the TNF-naïve group were generally higher.

And finally there was a pooled safety analysis of MEASURE 1 and 2 out to 52 weeks (poster #2887). There was a reassuringly low rate of SAEs and discontinuations due to adverse events, no TB, and no suicidality-related AEs.

I will be looking forward to adding secukinumab to our treatment options for AS.

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