SAT0268 Secukinumab demonstrates low radiographic progression and sustained efficacy through 4 years in patients with active ankylosing spondylitis
Authors: X. Baraliakos, J. Braun, A. Deodhar, D. Poddubny, P. Emery, E.M. Delicha, Z. Talloczy, B. Porter
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The MEASURE 1 core trial reported improved signs and symptoms of ankylosing spondylitis (AS) with secukinumab, a fully human anti–interleukin-17A monoclonal antibody.<sup>1</sup> <h3>Objectives</h3> To assess efficacy, including imaging outcomes, and safety from the MEASURE 1 extension trial (NCT01863732) up to 4 years. <h3>Methods</h3> Patients (pts) had completed 104 wks (2 years) in the core study with SC secukinumab 150 (IV→150 mg) or 75 mg (IV→75 mg) every 4 wks, following IV loading to Wk4, or placebo to Wk16/24. Efficacy data at Wk208 are reported for pts originally randomised to secukinumab 150 mg (approved dose). Lateral cervical and lumbar spine radiographs were assessed with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS), and MRIs with the Berlin SI joint total oedema score and Berlin spine score (derived from ASspi-MRI-a results). Images were evaluated by 2 central readers blinded to treatment/visit; mean scores were used. Descriptive statistics on observed/imputed data are provided. <h3>Results</h3> Of the 274 pts enrolled in this extension study, 89.7% (78/87) originally assigned to secukinumab 150 mg completed 208 wks. Δ mSASSS (mean ±SD) from baseline (BL) to Wk208 was numerically lower with secukinumab 150 mg (1.2±3.91) vs 75 mg (1.7±4.70). No definite radiographic progression (Δ mSASSS from BL &lt;2) was seen in 79% of pts on secukinumab 150 mg over 208 wks (figure 1). Mean Δ mSASSS at Wk208 was numerically higher in males, and in pts with BL syndesmophytes or elevated BL hsCRP. Reductions from BL in the Berlin SI joint oedema and Berlin spine scores were seen with secukinumab 150 mg. Sustained efficacy in signs/symptoms was seen through 208 wks (Table). Exposure-adjusted incidence rates per 100 pt-yrs (total exposure [mean ±SD]=3.4±1.44 years) were: serious infections (1.0), IBD (0.7), uveitis (1.8) and malignant/unspecified tumours (0.5). <h3>Conclusions</h3> Secukinumab 150 mg showed numerically lower radiographic progression vs 75 mg at 4 years. Secukinumab also demonstrated sustained efficacy on signs and symptoms, and MRI outcomes and a consistent safety profile.<sup>1</sup> <h3>Reference</h3> [1] Braun J, et al. Ann Rheum Dis2017;76:1070–7. <h3>Disclosure of Interest</h3> X. Baraliakos Grant/research support from: AbbVie, Merck, Pfizer, UCB, Novartis, and Chugai, Consultant for: AbbVie, Merck, Pfizer, UCB, Novartis, and Chugai, Speakers bureau: AbbVie, Merck, Pfizer, UCB, Novartis, and Chugai, J. Braun Grant/research support from: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB, Consultant for: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Cetocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB, Speakers bureau: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB, A. Deodhar Grant/research support from: AbbVie, Eli Lilly, GSK, Janssen, Novartis, Pfizer, UCB, Consultant for: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, UCB, D. Poddubny Grant/research support from: AbbVie, MSD, Novartis, Consultant for: AbbVie, BMS, MSD, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, BMS, Janssen, MSD, Novartis, Pfizer, UCB, P. Emery Consultant for: AbbVie, BMS, Merck, Novartis, Pfizer, Roche, UCB, E. Delicha Employee of: Novartis Pharma AG, Z. Talloczy Shareholder of: Novartis, Employee of: Novartis Pharmaceuticals Corporation, B. Porter Shareholder of: Novartis, Employee of: Novartis Pharmaceuticals Corporation