Clinical and Economic Benefit of Advanced Therapies for the Treatment of Active Ankylosing Spondylitis

Walsh, Jessica A.; Saffore, Christopher D.; Collins, Eric B.; Ostor, Andrew

doi:10.1007/s40744-023-00586-6

Cited by 3 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the use of TNFα inhibitors and IL-17A inhibitors in AS treatment is limited due to their side effects and high costs. [33][34][35] Traditional…”

Section: Discussionmentioning

confidence: 99%

“…Both TNF‐α and IL‐17A play crucial roles in the development of AS. However, the use of TNF‐α inhibitors and IL‐17A inhibitors in AS treatment is limited due to their side effects and high costs 33–35 . Traditional Chinese medicine (TCM) offers a promising approach with its multi‐targeted, bi‐directional, and systemic modulating effects that result in fewer side effects.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mechanistic study on the improvement of immune inflammation in ankylosing spondylitis through regulation of the PI3K/AKT signaling pathway by Huangqin Qingre Chubi capsules

Cong,

Liu,

Huang

et al. 2024

Int J of Rheum Dis

View full text Add to dashboard Cite

ObjectiveThis study aims to investigate the potential mechanisms by which the Hangqin Qingrechubi capsule (HQC) improves immunoinflammation in Ankylosing Spondylitis (AS).MethodsThe study combines systemic network pharmacology to predict, identify, and validate the core targets of HQC and AS. We conducted molecular docking to validate the interaction between the key active ingredients of HQC and the selected core targets associated with the PI3K/AKT signaling pathway, and employed data mining to delve deeper into the correlation between HQC usage and the improvement of clinical immunoinflammatory indicators. Additionally, AS‐PBMCs and FLS co‐culture cell models will be employed to further explore the mechanism of action of HQC in improving AS immune inflammation.ResultsBased on network pharmacology core target prediction, TNF‐α, IL‐17A, IL‐6, IL‐10, and AKT1 were identified as core targets, and KEGG enrichment analysis suggested that PI3K/AKT, IL‐17, and TNF might be key signaling pathways of HQC in improving immune inflammation in AS. The results of molecular docking demonstrated a favorable binding energy between the selected AKT1 core target and the key active components of HQC, including baicalin, baicalein, and quercetin. Clinical data mining revealed a significant correlation between HQC use and improvement in clinical immunoinflammatory indexes, such as ESR, CRP, IgA, IgM, IgG, C3, C4, patient perception scores (VAS, SAS, SDS), and (PF, SF) scores. In vitro cellular experiments further supported the significant ability of HQC to inhibit PI3K/AKT signaling pathway activation.ConclusionHQC, as an herbal compound preparation, exhibits anti‐inflammatory effects through multiple components and targets, making it a potential treatment option for AS. Furthermore, an underlying mechanism of action of HQC is its ability to ameliorate immune inflammation in AS patients by inhibiting the PI3K/AKT signaling pathway.

show abstract

“…However, the use of TNFα inhibitors and IL-17A inhibitors in AS treatment is limited due to their side effects and high costs. [33][34][35] Traditional…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mechanistic study on the improvement of immune inflammation in ankylosing spondylitis through regulation of the PI3K/AKT signaling pathway by Huangqin Qingre Chubi capsules

Cong,

Liu,

Huang

et al. 2024

Int J of Rheum Dis

View full text Add to dashboard Cite

show abstract

Comparative Efficacy of Advanced Therapies in the Treatment of Radiographic Axial Spondyloarthritis or Ankylosing Spondylitis as Evaluated by the ASDAS Low Disease Activity Criteria

Baraliakos,

Saffore,

Collins

et al. 2024

Rheumatol Ther

View full text Add to dashboard Cite

Introduction With an increasing number of biologic/targeted synthetic disease-modifying antirheumatic drug options available for the treatment of active ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis, it is of clinical interest to determine the comparative efficacy of these advanced therapies among populations with differing prior advanced therapy exposure. This study aimed to assess the comparative efficacy of approved advanced therapies for AS in tumor necrosis factor inhibitor (TNFi)-naïve and, separately, in TNFi inadequate responder/intolerant (-IR) populations. Methods A systematic literature review was conducted to identify randomized clinical trials for TNFis, interleukin-17A inhibitors, and Janus kinase inhibitors used as advanced therapies for active AS. Clinical efficacy was considered by the Ankylosing Spondylitis Disease Activity Score low disease activity (ASDAS LDA) criteria, defined as ASDAS score less than 2.1, among approved therapies. Comparative efficacy in the TNFi-naïve population was assessed utilizing network meta-analysis, while comparative efficacy in the TNFi-IR population was assessed utilizing matching-adjusted indirect comparison. Odds ratios were calculated, from which absolute rates and numbers needed to treat were calculated. Safety in the form of trial-reported and placebo-adjusted rates of discontinuation due to adverse events (AEs) was reviewed. Results Among the TNFi-naïve population, the estimated ASDAS LDA rate between week 12 and 16 was highest for patients treated with upadacitinib (52.8%) and lowest for patients treated with placebo (11.6%). Among the TNFi-IR population, the estimated ASDAS LDA rate was 41.3% for patients treated with upadacitinib and 17.5% for patients treated with ixekizumab. The trial-reported and placebo-adjusted rates of discontinuation due to AEs were generally low across included advanced therapies. Conclusions Relative to other assessed therapies, upadacitinib demonstrated greater clinical efficacy per ASDAS LDA in the treatment of active AS in both TNFi-naïve and TNFi-IR populations. Head-to-head and real-world data comparisons are warranted to both validate these findings and aid medical decision makers. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-024-00685-y.

show abstract

Effectiveness and safety of BCD180, anti-TRBV9<sup>+</sup> T-lymphocytes monoclonal antibody in patients with active radiographic axial spondyloarthritis: 36-week results of double-blind randomized placebo-controlled phase II clinical study ELEFTA

Nasonov,

Mazurov,

Lila

et al. 2024

Naučno-praktičeskaâ revmatologiâ

View full text Add to dashboard Cite

The aim – to evaluate the clinical effectiveness, safety, pharmacokinetics, pharmacodynamics, and immunogenicity of seniprutug (BCD-180) in patients with radiographic active axial spondyloarthritis (r-axSpA, or ankylosing spondylitis).Subjects and methods. 260 patients with active r-axSpA and inadequate response to nonsteroidal anti-inflammatory drugs (NSAIDs) were randomized into three groups: seniprutug (BCD-180) at doses of 5 mg/kg or 7 mg/kg, or placebo. BCD-180 was administered on weeks 0–12–36. Patients in the placebo group were switched to BCD-180 at a dose of 5 mg/kg at week 24 and continued therapy at week 36. The primary endpoint was the proportion of patients achieving 40% improvement by Assessment in Spondyloarthritis International Society scale (ASAS40) at week 24. Secondary endpoints were proportion achieving ASAS20/40, improvement of 5 out of 6 criteria of ASAS (ASAS5/6), ASAS partial remission, clinically important improvement in ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score with C-reactive protein) (ASDAS-CII) and major improvement in ASDAS-CRP (ASDAS-MI). The dynamics of the disease activity status according to ASDAS-CRP, the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and BASFI (Bath Ankylosing Spondylitis Functional Index) indices, as well as the dynamics of laboratory markers (C-reactive protein anderythrocyte sedimentation rate (ESR)) were analyzed. Safety was assessed by the frequency and profile of adverse events (AEs) and adverse reactions (ARs).Results. The proportion of patients achieving ASAS40 at week 24 with seniprutug (BCD-180) at the dose of 7 mg/kg and 5 mg/kg was 51.4% and 40.8%, respectively, compared with 24% in the placebo group (p=0.0012 and p=0.0417, respectively). Analysis of secondary endpoints showed that in patients with r-axSpA, BCD-180 at both study doses was significantly superior to placebo at week 24 in the following measures: decrease in the proportion of subjects with very high disease activity (ASDAS-CRP>3.5) achieving ASDAS-CII, ASAS20, ASAS5/6. A statistically significant decrease in the ASDAS-CRP, BASDAI, BASFI indices, as well as the concentration of CRP and ESR were demonstrated. Tolerability of seniprutug therapy was assessed as acceptable. Infusion reactions were the most common observed adverse events, the vast majority of which were mild to moderate in severity according to CTCAE 5.0 (Common Terminology Criteria for Adverse Events) and developed predominantly during the first administration. The proportion of patients with binding antibodies was 5.1%. However, no neutralizing antibodies were detected.Conclusion. Seniprutug (BCD-180) demonstrated superiority over placebo in clinical efficacy with a favorable safety profile and low immunogenicity as a treatment of r-axSpA.

show abstract

Clinical and Economic Benefit of Advanced Therapies for the Treatment of Active Ankylosing Spondylitis

Cited by 3 publications

References 14 publications

Mechanistic study on the improvement of immune inflammation in ankylosing spondylitis through regulation of the PI3K/AKT signaling pathway by Huangqin Qingre Chubi capsules

Mechanistic study on the improvement of immune inflammation in ankylosing spondylitis through regulation of the PI3K/AKT signaling pathway by Huangqin Qingre Chubi capsules

Comparative Efficacy of Advanced Therapies in the Treatment of Radiographic Axial Spondyloarthritis or Ankylosing Spondylitis as Evaluated by the ASDAS Low Disease Activity Criteria

Effectiveness and safety of BCD180, anti-TRBV9<sup>+</sup> T-lymphocytes monoclonal antibody in patients with active radiographic axial spondyloarthritis: 36-week results of double-blind randomized placebo-controlled phase II clinical study ELEFTA

Contact Info

Product

Resources

About