medwireNews: Researchers have found that secukinumab performs equally well to adalimumab biosimilar for the treatment of radiographic axial spondyloarthritis (r-axSpA) in a head-to-head trial.
The phase 3b study – SURPASS – was presented at ACR Convergence 2022 in Philadelphia, Pennsylvania, USA, by Xenofon Baraliakos (Ruhr-Universität Bochum, Germany), who highlighted that it “is the very first and only study that has been conducted in [axSpA] with a head-to-head comparison in the main outcome of radiographic progression.”
Xenofon Baraliakos takes us through SURPASS, a phase 3b head-to-head trial that demonstrated equivalence of secukinumab versus adalimumab biosimilar in patients with radiographic axial spondyloarthritis (4:49).
While the study failed to meet its primary endpoint of secukinumab superiority over adalimumab biosimilar, spinal radiographic progression was low with both treatments, with no significant difference between the two after 2 years of treatment.
Baraliakos reported a progression-free rate of 66.1% and 66.9% among patients treated with secukinumab 150 mg and 300 mg, respectively, and 65.6% for those given adalimumab biosimilar. No radiographic progression was defined as a change in mSASSS from baseline of no more than 0.5 points.
In all, 859 biologic-naïve patients with active r-axSpA who had high-sensitivity C-reactive protein levels of at least 5 mg/L or one or more syndesmophytes on spinal radiograph participated in the study. They were randomly assigned to receive the interleukin-17A blocker secukinumab at a dose of 150 or 300 mg every 4 weeks, following loading doses at baseline and weeks 1, 2, 3, and 4, or 40 mg of the tumor necrosis factor (TNF) inhibitor adalimumab biosimilar given every 2 weeks.
“There was a tendency for lower radiographic progression with [the] IL-17 inhibitor, which means it did at least as good as the well-established TNF blockers,” said Baraliakos
At baseline, the mean mSASSS was 17.6 points and 16.5 points for the 287 and 286 patients taking secukinumab 150 mg and 300 mg, respectively, and 15.7 points for the 286 patients taking adalimumab biosimilar.
The least squares mean increases in scores from baseline to week 104 were a corresponding 0.54, 0.55, and 0.72 and there was no significant difference between secukinumab and adalimumab biosimilar.
Baraliakos and team also found that among patients with at least one syndesmophyte, just over half in each group did not develop a new one, with rates of 53.8 to 56.9% with secukinumab and 53.3% with adalimumab biosimilar.
Similarly, the data were comparable between the treatment groups for magnetic resonance imaging observations, edema score, and safety.
The safety outcomes were “consistent with the well-established safety profiles” for secukinumab and adalimumab biosimilar, Baraliakos reported, with adverse event rates of 79.7%, 81.8%, and 84.2% for patients treated with secukinumab 150 mg and 300 mg and adalimumab biosimilar, respectively.
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