SAT0259 Low rate of spinal radiographic progression over 2 years in ankylosing spondylitis patients treated with secukinumab: a historical cohort comparison
Authors: J. Braun, H. Haibel, M. de Hooge, R. Landewé, M. Rudwaleit, T. Fox, A. Readie, H.B. Richards, B. Porter, R. Martin, D. Poddubny, J. Sieper, D. van der Heijde
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Secukinumab, a fully human interleukin 17A (IL-17A) inhibitor, improved signs and symptoms of ankylosing spondylitis (AS) in patients (pts) in the MEASURE 1 core trial at 2 years and through 4 years in the extension study.<sup>1,2</sup> A low radiographic progression rate was reported for the modified Stoke Ankylosing Spondylitis Spinal Score (Δ mSASSS at Yr 2=0.3).<sup>1</sup> Comparison of anti-TNF agents with historical NSAID-treated cohorts have not shown a significant benefit at 2 years in reducing radiographic progression.<sup>3,4</sup> <h3>Objectives</h3> This retrospective analysis compared spinal radiographic progression over 2 years in the MEASURE 1 cohort of secukinumab-treated AS patients (C1; NCT01358175) vs a historical cohort of biologic-naïve AS pts (ENRADAS [C2; NCT00715091]).<sup>5</sup> <h3>Methods</h3> Baseline (BL) and 2 year X-ray data from the 2 cohorts were compared. Only data from pts with X-rays at BL and Yr 2 (data capture window for Yr 2 X-rays: 31–744 days) were included (n=168 [C1], n=69 [C2]). X-rays were independently re-evaluated using the mSASSS by 2 reviewers and an adjudicator blinded to the timing and cohorts; averaged values were analysed. Cases with the highest difference in Δ mSASSS between readers (top 10%) were adjudicated. The primary outcome was to compare the% pts with no radiographic progression (Δ mSASSS at Year 2≤0) in C1 vs C2. The difference between C1 and C2 was analysed using a logistic regression with cohort as a factor and BL mSASSS as a covariate. <h3>Results</h3> BL demographics were comparable across cohorts, with mean age 40.9 vs 42.6 years, and gender 72.8% vs 66.7% male in C1 vs C2, respectively. Over 2 years, least squares (LS) mean Δ mSASSS was 0.55 for C1 vs 0.89 for C2 (p=0.185) and% pts with no radiographic progression (Δ mSASSS at Year 2≤0) was slightly higher in C1 vs C2 (table 1). <h3>Conclusions</h3> Over 2 years, a numerically lower rate of progression was seen in secukinumab-treated pts vs a control cohort of biologic-naïve AS pts. Further research is needed to understand the impact of IL-17A inhibition with secukinumab on spinal disease progression in AS pts; SURPASS (NCT03259074), an ongoing H2H study powered to compare differences in spinal radiographic progression with secukinumab vs biosimilar adalimumab, will help answer these questions. <h3>References</h3> [1] Braun J, et al. Ann Rheum Dis Ann Rheum Dis2017;76:1070–77. [2] Braun J, et al. Arthritis Rheumatol2017;69(10). [3] van der Heijde D, et al. Arthritis Rheum2008;58:1324–31. [4] van der Heijde D, et al. Arthritis Res Ther2009;11:R127. [5] Sieper J, et al. Ann Rheum Dis2016;75:1438–43. <h3>Disclosure of Interest</h3> 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, Centocor, 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, H. Haibel: None declared, M. de Hooge Employee of: MdH Research, R. Landewé Grant/research support from: Abbott, Amgen, Centocor, Novartis, Pfizer, Roche, Schering-Plough, UCB and Wyeth, Consultant for: Abbott/AbbVie, Ablynx, Amgen, Astra-Zeneca, Bristol-Myers Squibb, Centocor, GlaxoSmithKline, Novartis, Merck, Pfizer, Roche, Schering-Plough, UCB and Wyeth, Employee of: Rheumatology Consultancy BV, Speakers bureau: Abbott, Amgen, Bristol-Myers Squibb, Centocor, Merck, Pfizer, Roche, Schering-Plough, UCB and Wyeth, M. Rudwaleit Speakers bureau: Abbvie, BMS, Celgene, Chugai, Janssen, MSD, Novartis, Pfizer, UCB, T. Fox Shareholder of: Novartis, Employee of: Novartis Pharma AG, A. Readie Shareholder of: Novartis, Employee of: Novartis Pharmaceuticals Corporation, H. Richards Shareholder of: Novartis, Employee of: Novartis Pharma AG, B. Porter Shareholder of: Novartis, Employee of: Novartis Pharmaceuticals Corporation, R. Martin Shareholder of: Novartis, Employee of: Novartis Pharmaceuticals Corporation, D. Poddubny Grant/research support from: Abbvie, Janssen, MSD, Novartis and Pfizer, Consultant for: AbbVie, Bristol-Myers Squibb, MSD, Novartis, Pfizer and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Janssen, MSD, Novartis, Pfizer, Roche and UCB, J. Sieper Grant/research support from: AbbVie, Boehringer Ingelheim, Janssen, Novartis, Merck, Lilly, Pfizer, and UCB, Consultant for: AbbVie, Janssen, Novartis, Merck, Lilly, Pfizer, Sun and UCB, Speakers bureau: AbbVie, Janssen, Novartis, Merck, Pfizer, Roche and UCB, D. van der Heijde Consultant for: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boeringer Ingelheim, Celgene, Daiichi, Eli-Lilly, Galapagos, Gilead, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi and UCB, Employee of: Imaging Rheumatology BV