Thursday, 17 Jan 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.

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

Add new comment

More Like This

Anakinra for Acute Crystal-Induced Arthritis

A retrospective analysis of hospitalized patients who also had a gout and pseudogout attack shows that injections of anakinra (interleukin-1 receptor antagonist) were highly effective and safe in nearly three-quarters of patients.  

Through a medical records search they found 100 patients and 115 episodes between 2014-2017 who were treated with anakinra for crystal arthritis. 

IL-6 Blocker Succeeds in Real-World Vasculitis

Tocilizumab (Actemra) was effective for refractory giant cell arteritis (GCA) in real-world practice, although serious infections occurred relatively frequently, Spanish investigators reported.

BMS Buyout of Celgene for $74 Billion

Reuters reports that Bristol-Myers Squibb (BMS) has announced its intention to buy Celgene Corp for nearly $74 billion in a cash-and-stock deal.

Celgene shareholders will receive one BMS share and $50 in cash per share (or $102.43 per share), and a premium of 53.7 percent to Celgene’s Wednesday close.

Severe Cutaneous Sarcoid Treated with Tofacitinib

Researchers from Yale have taken a novel approach and shown benefits when using tofacitinib in severe cutaneous sarcoidosis.

A report in the NEJM describes a 48-year-old female woman who was previously unresponsive to multiple medications and had not received systemic glucocorticoids. She was treated with tofacitinib 10 mg twice-daily and clinically responded with near disappearance of her skin lesions..

Best of 2018: Unproven But Profitable Stem Cell Clinics

Stem cell clinics are popular and proliferating as they are largely a cash business and fall outside of FDA regulatory control. In lieu of scientific proof, most advocates use patient testimonials and the placebo effect to back up their claims.