Secukinumab Shows Efficacy in Two Ankylosing Spondylitis Trials Save

NEJM has published the results of two studies wherein IL-17 inhibition with secukinumab (SEC) was shown to be effective in patients with anklylosing spondylitis. (Citation source http://buff.ly/1VAndEl)

The MEASURE 1 and MEASURE 2 trials enrolled a total of 590 patients with active AS.  In MEASURE 1, patients received either placebo or SEC (given IV at 10 mg/kg at weeks 0, 2, and 4, followed by subcutaneous 150 mg or 75 mg every 4 weeks after week 8).  In MEASURE 2, 218 AS patients received either placebo or SEC 75 mg sc or SEC 150 mg weekly for 4 weeks, then monthly for 3 months. Patients were 70-80% HLA-B27+ and 61-74% were naive to TNF inhibition.

Week 16 results showed signficant ASAS20 responses in the MEASURE 1 study (with IV loading) for SEC 150 mg (61%) and SEC 75 mg (60%) dose groups (compared to 29% with placebo).  MEASURE 2 (no IV loading) showed similar results for SEC 150 mg (60%) and SEC 75 mg (41%) compared to placebo (28%). Long-term success was seen through week 52 as 319 patients (86%) in MEASURE 1, and 181 patients (83%) in MEASURE 2 maintained similar clinical responses. No new or surprising safety signals were seen as less than 1% of patients in both trials had either candida infections, new Crohn's disease or grade 3/4 neutropenia.

IL-17 inhibition with SEC represents a significant new advance and alternative in the treatment of patients with ankylosing spondylitis.