Secukinumab: A Review in Ankylosing Spondylitis
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ADIS DRUG EVALUATION
Secukinumab: A Review in Ankylosing Spondylitis Hannah A. Blair1
© Springer Nature Switzerland AG 2019
Abstract Secukinumab (Cosentyx®), a first-in-class fully human monoclonal antibody against interleukin-17A, is approved in several countries, including the USA and those of the EU, for the treatment of ankylosing spondylitis (AS). Subcutaneous secukinumab significantly improved the clinical signs and symptoms of AS versus placebo in three of four phase III trials. The benefits of secukinumab were generally seen regardless of whether patients had or had not received previous tumour necrosis factor (TNF) inhibitor therapy, and were sustained during longer-term (up to 5 years) treatment. Secukinumab was also associated with improvements in spinal mobility, physical function, health-related quality of life and work productivity in some of the trials. In MEASURE 1, secukinumab reduced inflammation in the sacroiliac joint, and slowed radiographic progression. Secukinumab was generally well tolerated during up to 5 years’ treatment; the most commonly reported adverse event was nasopharyngitis. In the minority of patients who developed anti-drug antibodies (ADAs), ADAs did not decrease efficacy or increase adverse events. In conclusion, secukinumab is an effective therapy for TNF inhibitor-naive patients with active AS, and provides a useful treatment option for patients who have an inadequate response to or are intolerant of TNF inhibitors.
Secukinumab: clinical considerations in AS
1 Introduction
Improves clinical signs and symptoms of AS, with benefits sustained during longer-term treatment
Ankylosing spondylitis (AS) is a chronic, autoimmune inflammatory disease that primarily affects the axial skeleton [1]. Characteristic symptoms include chronic back pain, stiffness and progressive loss of spinal mobility [1, 2]. If not adequately treated, AS can lead to significant disability (including total fusion of the axial skeleton) and impaired quality of life (QOL) [1]. NSAIDs are the first-line recommended agents for the treatment of active AS [3, 4]. For patients whose disease remains active despite conventional treatment with NSAIDs [3, 4], the advent of tumour necrosis factor (TNF) inhibitors has revolutionized the treatment landscape [5]. However, some patients fail to respond adequately to TNF inhibitors or develop tolerability issues, and the efficacy of TNF inhibitors can wane over time. New treatment options for these patients are now available, including interleukin (IL)-17 inhibitors [5]. IL-17A, a member of the IL-17 family, is a cytokine involved in normal inflammatory and immune responses [6]. IL-17A has been shown to play an important role in the pathogenesis of AS [7]. Indeed, studies have demonstrated increased numbers of IL-17A-producing cells in the circulation and the subchondral bone marrow of joints in patients with AS [7]. Secukinumab ( Cosentyx®) is the first IL-17A inhibitor approved for the treatment of
Improves spinal mobility, physical function, healthrelated quali
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