Anti-IL17A in Axial Spondyloarthritis-Where Are We At?

Peter P Cheung

doi:10.3389/fmed.2017.00001

Abstract

Knowledge regarding the mechanisms of the IL17–IL23 pathway and its role in spondyloarthritis (SpA) has been pivotal to the development of IL-17 blockade in patients with axial SpA. Previously, only anti-TNF has proven to be clinically efficacious in patients with active disease, despite non-steroidal anti-inflammatory drugs and physiotherapy. However, up to 50% fail to achieve a clinically significant response. Secukinumab, a fully humanized monoclonal antibody targeting IL-17A, has recently been approved for use in patients with active ankylosing spondylitis. Clinical studies and current issues surrounding the use of secukinumab will be discussed.

Highlights

Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton and possibly the peripheral joints and entheses with a major impact on quality of life [1]. It is the prototype of several inter-related inflammatory arthritides, referred to as spondyloarthritis (SpA), and grouped together as it shares a number of common genetic, pathogenic, and phenotypic features [1]
Knowledge regarding the mechanisms of the IL17–IL23 pathway has increased with genetic, Anti-IL17A in Axial Spondyloarthritis experimental models and functional data suggesting that it plays a crucial role in SpA [16, 17]
Around 30% were not anti-TNF naïve. Inclusion criteria such as disease activity and failure of first-line therapy with Non-steroidal anti-inflammatory drugs (NSAIDs) were comparable to pivotal antiTNF trials [4,5,6,7], patients with spinal ankylosis were excluded in both MEASURE 1 and MEASURE 2

Summary

INTRODUCTION

Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton and possibly the peripheral joints and entheses with a major impact on quality of life [1]. Like other pivotal anti-TNF trials [4,5,6,7], the primary outcome was the proportion of patients achieving ASAS20 [Table 1; [31]] and was achieved in 59% of patients at 6 weeks. This paved way to Phase 3 clinical studies of secukinumab in AS (MEASURE 1, n = 371 and MEASURE 2, n = 219) [32].

Response criteria Components included in the response criteria

Radiographic Progression

Safety Information

CURRENT ONGOING STUDIES

Findings

OTHER PROMISING THERAPIES