Efficacy and Safety of Anti-Interleukin-17A Monoclonal Antibody Secukinumab in Treatment of Ankylosing Spondylitis: A Meta-Analysis

Abstract

Different signaling pathways have been studied in ankylosing spondylitis. New treatment options such as secukinumab could have an important role inhibiting the release of proinflammatory cytokine IL-17. The aim of this study was to compare the efficacy and safety of secukinumab in ankylosing spondylitis. A systematic review was conducted using MEDLINE and EMBASE databases to identify randomized clinical trials (RCTs) that assess the role of secukinumab in ankylosing spondylitis. The variables were safety (total adverse events, serious adverse events, headache, nasopharyngitis, cough, deaths, discontinuation due to adverse events, candida, neutropenia, and diarrhea) and efficacy based on quality-of-life scores (ASAS 20, ASAS 40, ASAS 5/6, ASASPR). Three RCTs (770 patients) that compare secukinumab with placebo were included in the study. There were significant differences in the quality-of-life scores in favor of the secukinumab group ( p < 0.05). Regarding the adverse events, there were higher rates of any adverse events in the secukinumab group ( p < 0.05). Also, the secukinumab group showed a higher rate of nasopharyngitis and diarrhea ( p < 0.05). The use of secukinumab in ankylosing spondylitis increased the quality of life and had more adverse events rate compared with placebo.

Evidence for the Use of Secukinumab in Patients with Radiographic and Non-radiographic Axial Spondyloarthritis in the Last 5 Years

“…The magnitude and direction of the primary endpoint results from the MEASURE studies have been confirmed in meta-analyses [ 26 , 27 ]. Similarly, these studies showed significant improvements in the secondary endpoints of disease activity, such as C-reactive protein (CRP) levels, Ankylosing Spondylitis Disease Activity Score (ASDAS), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), relative to placebo [ 16 , 19 – 21 ].…”

Overview of Research on the Treatment of Ankylosing Spondylitis in Chinese Medicine

“…The pillars of treatment for ankylosing spondylitis are nonsteroidal anti-inflammatory drugs, which provide greater relief from spinal pain and moderate benefit in restoring body function. However, NSAIDs can only strictly control symptoms; they are a class of anti-inflammatory drugs that do not contain steroidal structures; the drugs have anti-inflammatory, antiicoagulant, anti-rheumatic, analgesic and antipyretic effects; they do not alter the course of the disease or prevent structural damage.Corticosteroids, Anti-TNF [5], interleukin 17A [6] [7] and various dark and emerging biologic therapies are also frequently used in clinical settings to treat AS patients. However, the results of these treatments have not been satisfactory.…”

Treating Psoriatic Arthritis By TNF –Α Inhibitors: A Case Study

“…Secukinumab (monoclonal antibody to IL-17A) is effective in psoriasis. 16 A new drug for PsA treatment (Apremilast) is an inhibitor of phosphodiesterase-4 16 ; its favorable safety profile in the absence of the need for regular blood monitoring and hepatotoxicity may be an advantage in practice. Prior to administering genetically engineered biological preparations (GEBP), it is necessary to perform the examination for tuberculosis, X-ray of the thoracic cavity, every 6 months it is necessary to assess the dynamics of these indicators.…”