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The Holy Grail: Does Secukinumab Inhibit Radiographic Progression in AS?
June 9 2016 12:10 AM ET — via RheumReports
Greetings from London! Today we hit the ground running with a clinical science session called Axial spondyloarthritis and psoriatic arthritis : Emerging pathways.
The session opened with a nice overview of the IL-17, IL-22 and IL-23 pathways as well as the potential role of biomechanic stress in the development of SpA. Then the session addressed the question on all of our minds: What about radiographic progression in AS? Is there finally an agent which will stop progression of this disease?
Dr Juergen Braun presented radiographic data from the MEASURE 1 study. This was a trial of 1371 patients with active AS randomized to receive secukinumab or placebo with two IV loading doses followed by either 75 or 150 mg sc q4 weeks. Placebo patients were re-randomized at week 16 or 24 depending on ASAS response. Radiographs were performed at baseline and week 104 and read by independent readers applying mSASSS criteria.
The mean change in mSASSS was very low in secukinumab treated patients with no difference between doses. There was no progression in 80% of patients treated. Radiographic changes were higher in male patients, those who had baseline syndesmophytes or elevated baseline CRP. There was no difference in TNF-naive vs TNF inadequate responders.
Although there was no radiographic progression seen and there may be a lower rate of progression than with a TNF inhibitor, obviously there have been no direct comparisons so no conclusions can be drawn. The bottom line is that this is encouraging but by no means the end of the story. We welcome secukinumab into our armamentarium for treating AS but hope for more radiographic data to come.
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About the Author
Dr. Shelly Dunne
Dr. Shelley Dunne is a graduate of Memorial University of Newfoundland School of Medicine. She completed her training in Internal Medicine and a fellowship in Rheumatology at the University of Toronto. She has been in private practice since 1998 and is currently a consulting rheumatologist at the Toronto East General Hospital.
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