Secukinumab: A Review in Ankylosing Spondylitis

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.

<p>Therapeutic Potential of Ixekizumab in the Treatment of Ankylosing Spondylitis: A Review on the Emerging Clinical Data</p>

“…15 A few studies from real-life clinical practice, on a limited number of patients, confirmed the results of RCTs. 15 Secukinumab safety profile was satisfactory, with a slight increased risk for infections, 31 no increased risk of latent tuberculosis (TB) reactivation. 34 Due to the physiological protective role exerted by IL-17 on mucosae, 35 and on gut microbiome, 36 a special attention was reserved to the risk of opportunistic infections and increased occurrence of inflammatory bowel diseases induced by IL-17 inhibition.…”

“…33 The efficacy of secukinumab in AS at the dose of 150 mg/sc/was demonstrated in 5 RCTs of MEASURE program. 15 Overall, the drug significantly reduced the disease activity, improved the quality of life, with slowing down of the structural damage both in naïve and anti-TNF refractory AS patients. 15 A few studies from real-life clinical practice, on a limited number of patients, confirmed the results of RCTs.…”

“…15 Overall, the drug significantly reduced the disease activity, improved the quality of life, with slowing down of the structural damage both in naïve and anti-TNF refractory AS patients. 15 A few studies from real-life clinical practice, on a limited number of patients, confirmed the results of RCTs. 15 Secukinumab safety profile was satisfactory, with a slight increased risk for infections, 31 no increased risk of latent tuberculosis (TB) reactivation.…”

“…Recently, the pivotal pathogenic role of IL-17 in AS was demonstrated, 14 and, randomized controlled trials (RCTs) evidenced the efficacy and safety of secukinumab, an anti-IL-17 targeted monoclonal antibody. 15 In two recent RCTs, ixekizumab, an anti-IL-17a monoclonal antibody, resulted highly efficacious and safe for the treatment of AS. 16 The present review was focused on the pharmacological characteristics of ixekizumab, the peculiarity of its mechanism of action, the efficacy and safety, and its place in therapy of AS.…”

Role of secukinumab in ankylosing spondylitis with tubercular uveitis

“…The newer agent, IL17-A inhibitor, has proved to be useful for (a) TNF inhibitor-naive patients with active AS, and also for (b) those who have a poor response to (or, are intolerant) to TNF inhibitors. [ 5 ]…”