Inflammation tied to magnitude of secukinumab response in nonradiographic axSpA
medwireNews: Treatment with secukinumab improves outcomes for people with nonradiographic axial spondyloarthritis (axSpA) across different subgroups, but those with objective signs of inflammation may experience the greatest benefits, suggests a post-hoc analysis of the PREVENT trial.
The main findings from the phase 3 study, reported previously by medwireNews, showed that the interleukin-17A inhibitor significantly improved the signs and symptoms of nonradiographic axSpA relative to placebo.
In the post-hoc analysis, reported in Arthritis Research & Therapy, Jürgen Braun (Ruhr-University Bochum, Germany) and co-investigators found that the between-group difference in efficacy was highest in the subgroup of participants with both elevated C-reactive protein levels and evidence of sacroiliitis on magnetic resonance imaging at baseline. ASAS40 response rates at week 16 in this subgroup were 52.3% for the 111 patients treated with secukinumab versus 21.8% for the 55 given placebo.
These findings support previous study results showing that objective signs of inflammation at baseline are positive predictors of response to tumor necrosis factor (TNF) inhibitor therapy, say the researchers. However, they note that unlike previously suggested for TNF inhibitors, human leukocyte antigen-B27 status had a “minimal” impact on secukinumab response in the present study.
The team also observed differences in secukinumab efficacy by sex, with significantly higher ASAS40 response rates with secukinumab versus placebo among men (51.2 vs 30.8%) but not women (31.7 vs 25.3%).
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