Minimal Radiographic Progression Over 2 Years With Secukinumab for NrAxSpa

Most patients treated with secukinumab for nonradiographic axial spondyloarthritis (NrAxSpa) had no radiographic progression in their sacroiliac (SI) joints and spine, according to 2-year results from a phase 3 trial published online in Arthritis Research & Therapy.

Additionally, researchers wrote, “secukinumab reduced SI joint inflammation, which was sustained over 2 years.” 

The study included 438 patients with NrAxSpa who completed week 104 of the PREVENT study. PREVENT randomized adults with NrAxSpa to secukinumab 150 mg or placebo, then at week 52, all patients received open-label secukinumab. Researchers investigated radiographic progression and the course of inflammation in each of the secukinumab and secukinumab-placebo groups over the trial’s 2 years. 

Some 87.7% of patients in the secukinumab group and 85.6% in the placebo-secukinumab group showed no structural progression in SI joint score over 2 years, according to the study. On the modified Stoke Ankylosing Spondylitis Spine Score, 97.5% in the secukinumab group and 97.1% in the placebo-secukinumab group showed no structural progression.

Among patients who scored as modified New York-negative at baseline, 3.3% and 2.9% of patients in the secukinumab and placebo-secukinumab groups, respectively, were modified New York-positive at week 104, researchers reported.

The study also found that week 16 reductions in SI joint bone marrow edema in patients randomized to secukinumab were sustained through week 104. Magnetic resonance imaging showed low spinal inflammation at baseline, which remained low throughout the study.

“This is one of the largest imaging datasets in patients with NrAxSpa available to date,” researchers wrote. “The overall radiographic changes, along with any changes in spinal inflammation, in a population of patients on an effective biologic therapy were minimal over time, while a reduction in SI joint inflammation was observed.”

Reference: 
Braun J, Blanco R, Marzo-Ortega H, et al. Two-year imaging outcomes from a phase 3 randomized trial of secukinumab in patients with non-radiographic axial spondyloarthritis. Arthritis Res Ther. 2023 May;25(1):80. doi:10.1186/s13075-023-03051-5