medwireNews: The UK’s National Institute for Health and Care Excellence (NICE) has recommended the use of interleukin (IL)-17A inhibitor ixekizumab for the two main types of axial spondyloarthritis (axSpA), while the indication for secukinumab has been expanded to include nonradiographic axSpA.
Ixekizumab is now recommended for patients with active ankylosing spondylitis and an inadequate response to conventional therapy, as well as those with active nonradiographic axSpA and an inadequate response to nonsteroidal anti-inflammatory drugs (NSAIDs). Ixekizumab may only be given to patients for whom tumor necrosis factor (TNF) inhibitors are not suitable, or those with an insufficient response to TNF inhibitors.
The NICE recommendation is based on data from the COAST-V, COAST-W, and COAST-X trials, and follows the European regulatory approval announced in 2020.
Click through for a guide to the phase 3 trials of IL-17A inhibitors in ankylosing spondylitis
NICE has also expanded its recommendation for secukinumab use. Previously supported for ankylosing spondylitis in the UK, the agent may now also be given to people with nonradiographic axSpA and objective signs of inflammation who have an inadequate response to NSAIDs. Similar to ixekizumab, secukinumab is recommended only if TNF inhibitors are unsuitable or elicit an inadequate response.
The recommendation for secukinumab is based on data from the PREVENT trial, which showed that patients with nonradiographic axSpA treated with the IL-17A inhibitor had a significantly greater reduction in disease activity than those given placebo.
Writing in a press release, Raj Sengupta, from the Royal National Hospital for Rheumatic Diseases in Bath, UK, said: “The NICE decision is a key milestone for clinicians and patients who will now have access to an additional treatment option that may help patients.”
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