medwireNews: Treatment with the interleukin(IL)-17A inhibitor secukinumab leads to clinical improvement of spondyloarthritis (SpA) and immunomodulation in target tissues without having a negative effect on the systemic immune response, researchers report.
In an open-label trial, 65% of 20 patients with peripheral SpA who were treated with secukinumab (300 mg/week for 4 weeks followed by every 4 weeks thereafter) experienced at least a 20% improvement in ACR criteria by the 12-week follow-up.
Histopathologic analysis revealed that this clinical response was accompanied by a significant decrease in CD15+ neutrophils and synovial sublining CD68+ macrophages, which are “both sensitive biomarkers for synovial inflammation in SpA,” explain Leonieke van Mens (University of Amsterdam, the Netherlands) and co-investigators.
However, with the exception of IL-17A itself, secukinumab treatment did not affect the ability of peripheral blood cells to produce a range of 30 different cytokines and chemokines, including “key host defense factors” such as tumor necrosis factor alpha and interferon gamma.
These findings indicate that “IL-17A blockade with secukinumab has a profound clinical and immunopathological impact on [peripheral] SpA without compromising systemic immune responses,” conclude the researchers in Arthritis & Rheumatology.
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