Meta-analysis shows ‘favorable response rates’ with IL-17A inhibitors in ankylosing spondylitis
medwireNews: A meta-analysis of phase 3 trials indicates that interleukin (IL)-17A inhibitors have clinical efficacy for the treatment of ankylosing spondylitis (AS), but at the cost of an increased risk for non-severe infections.
Yufeng Yin (The First Affiliated Hospital of Soochow University, Suzhou, China) and colleagues analyzed data from six randomized controlled trials including a total 1733 patients with active AS from over 100 centers across Asia, North and South America, and Europe. The patients were treated with either an IL-17A inhibitor or placebo; four trials (MEASURE 1–4) investigated the IL-17A inhibitor secukinumab, while two (COAST-V and COAST-W) investigated ixekizumab.
The researchers report in Arthritis Research & Therapy that secukinumab and ixekizumab “produced favorable response rates,” with IL-17A inhibitor-treated patients being significantly more likely to achieve an ASAS20 response than those given placebo.
Specifically, ASAS20 response rates at week 16 were 57.6% for the 1153 participants in the IL-17A inhibitor group compared with 35.3% for the 580 placebo-treated patients, giving a risk ratio (RR) of 1.63 favoring active treatment.
Yin and team found “similar results” when analyzing the two drugs separately, with ASAS20 response rates of 58.4% and 35.7%, respectively, for secukinumab versus placebo (RR=1.64) and 55.9% versus 34.6% for the comparison between ixekizumab and placebo (RR=1.63). They say that there was “a trend towards a higher ASAS20 response rate” among IL-17A inhibitor-treated patients who were tumor necrosis factor (TNF) inhibitor-naïve relative to those with a previous inadequate response to a TNF inhibitor.
In the safety analysis, rates were significantly higher in the IL-17A inhibitor versus the placebo group for treatment-emergent adverse events (AEs, 57.2 vs 51.4%) and non-severe infections (27.4 vs 15.0%). The most commonly reported infections were upper respiratory tract infections and nasopharyngitis, and most infections were mild or moderate.
The researchers say that there was no significant difference in the risk for death, discontinuation due to AEs, or serious AEs among people treated with IL-17A inhibitors versus placebo.
Therefore, “IL-17 inhibitors can be considered a favorable option for patients with active ankylosing spondylitis,” they conclude.
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