Thursday, 25 Apr 2019

You are here

IL-23 Inhibitor Fails in Ankylosing Spondylitis

A study of the IL-23 risankizumab in active ankylosing spondylitis (AS) patients failed to show efficacy and did not meet primary efficacy endpoints in a 6-month trial.

Risankizumab (RIZ) is a new, humanised anti-IL-23 monoclonal antibody that targets the p19 subunit of interleukin-23 (IL-23). It was studied in a 24-week trial involving 159 biologic-naïve, active AS patients. The primary outcome was a 40% improvement in Assessment in Spondylo Arthritis International Society (ASAS40) at week 12. 

In this placebo-controlled trial, the ASAS40 response rates were nearly the same for all groups 25.5%, 20.5%, 15.0%, and 17.5% (RIZ 18 mg, 90 mg, 180 mg and placebo groups). Adverse event rates were similar in all treatment groups.

While IL-23 inhibition (with this agent and another-guselkumab) has shown significant efficacy and benefits in cutaneous psoriasis and psoratic arthritis, the same has not been shown for patients with AS or axial spondyloarthritis. This in contrast to the efficacy of biologic inhibition of IL-17 (eg, secukinumab) and IL-12/23 (ustekinumab) that have shown efficay in SpA.

These data suggest that IL-23 alone may not be a primary driver of inflammation in AS.

The author has received compensation as an advisor or consultant on this subject

Add new comment

More Like This

Ustekinumab Effective in Behcet's Disease

A small prospective study has shown that ustekinumab is safe and effective in Behçet's disease (BD) with recurrent oral ulcers (OU).

Polypharmacy Blunts Responses and Ups the Safety Risks

A study from the British Society for Rheumatology Biologics Register (BSRBR-RA) demonstrates that polypharmacy is a predictor of lower treatment responses and more serious adverse events (SAEs) in rheumatoid arthritis (RA) patients.

RheumNowLive On Demand: Development & Use of JAK Inhibitors - Dr. John O'Shea

A clip from RheumNow Live On Demand. You can access the full library of content from the meeting.

For RA With COPD, Abatacept is Safe

Patients with rheumatoid arthritis (RA) who also had chronic obstructive pulmonary disease (COPD) had no increased risk of serious respiratory complications when treated with abatacept (Orencia), a large claims-based analysis found.

Ups and Downs with Abatacept

Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.