Dual Cytokine Inhibition for RA Save

The notion of a single biologic targeting two cytokines is intriguing. ABT-122 is a new dual-variable domain immunoglobulin that neutralizes both TNF-α and IL-17A. In an abstract presented today (abstract #3225), Dr. Mark Genovese, et al investigated long-term safety and efficacy of ABT-122 in RA patients that had completed a 12-week phase 2, randomized, double-blind, controlled study in which they were randomized to receive ABT-122 (3 different doses) or adalimumab in addition to methotrexate. That study, presented during the poster session on Sunday (abstract #650), showed at least comparable efficacy.

Now presented are results of a 24-week open-label extension study of 158 patients receiving background MTX, investigating for safety and maintenance of efficacy. ABT-122 showed consistent efficacy at 36 weeks, including in patients switching from adalimumab.

Naturally, one would be concerned about the safety profile of a dual cytokine inhibitor, however neither study showed increased frequency of AEs with ABT-122 compared to adalimumab, including no OIs.

An abstract presented on Monday by Khatri A. et al (abstract #1715) compared ABT-122 and adalimumab in PsA subjects who had an inadequate response to methotrexate. Dr. Philip Mease presented this study during the SpA abstract session, and ABT-122 showed no significant difference in ACR20/50/70 or PASI compared to adalimumab.

So far in PsA and RA it seems that while safe and efficacious, adding IL-17 inhibition to anti-TNF does not have added benefits.