FRI0386 RELATIONSHIP BETWEEN ASDAS STATES AND INHIBITION OF STRUCTURAL DAMAGE PROGRESSION WITH SECUKINUMAB IN ANKYLOSING SPONDYLITIS: DATA FROM MEASURE 1 TRIAL
Authors: Xenofon Baraliakos, Helena Marzo-Ortega, Filip van den Bosch, Atul Deodhar, Erhard Quebe-Fehling, Eumorphia Maria Delicha, Zsolts Talloczy, Corine Gaillez
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The primary treatment goal in patient with axial Spondyloarthritis (axSpA) is to optimize health-related quality of life through control of signs and symptoms, no structural damage progression and preservation of function.<sup>1</sup> The 2017 Treat to Target recommendations (T2T) outlined Ankylosing Spondylitis Disease Activity Score (ASDAS) -inactive disease (ID) as an optimal treatment target for axSpA patients.<sup>1</sup> ASDAS states were shown to correlate with syndesmophyte formation as assessed with X-Ray and MRI changes.<sup>2</sup> Secukinumab, a fully human monoclonal antibody that directly inhibits IL-17A, demonstrated sustained efficacy and low radiographic progression through 4 years in patient with ankylosing spondylitis (AS) in MEASURE 1 study (NCT01863732).<sup>3</sup> <h3>Objectives</h3> To investigate the relationship between ASDAS states and inhibition of radiographic structural progression in patient with AS treated with secukinumab 150 mg from the MEASURE 1 study over 4-years using <i>post hoc</i> analysis. <h3>Methods</h3> Lateral radiographs of the cervical and lumbar spine were assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS: range 0-72). Images were scored twice at baseline/Week (Wk) 104 and baseline/Wk 208 by 2 central readers blinded to treatment/visit; mean change from baseline to Wk 104 or 208 in mSASSS scores were used. The ASDAS-CRP was used to define the disease activity states at Wks 16, 52, 104, and 208: ID (ASDAS-CRP &lt; 1.3), Low Disease Activity (LDA, 1.3 ≤ ASDAS-CRP &lt; 2.1) or pooled High/Very High Disease Activity (HDA/VHDA, ASDAS-CRP ≥ 2.1) given low number of patients with VHDA. Sustained ASDAS state at Wk 104 was defined as reaching the same state at Wk 104 and Wk 16 and/or 52. Sustained ASDAS state at Wk 208 was defined as reaching the same state at Wk 208 and Wk 16 and/or 52. Overall, 87 patients on secukinumab 150 mg were in the extension trial; of these, 57 and 71, respectively, had evaluable X-rays at Wks 104 and 208. <h3>Results</h3> The proportion of patients achieving each ASDAS state are shown in <b>Table</b>. Patients with ASDAS-ID were associated with numerically lower mSASSS mean change from baseline to Wks 104/208 compared to other ASDAS states (<b>Figure</b>). <h3>Conclusion</h3> In this <i>post hoc</i> analysis, patients with ASDAS-ID state and sustained ASDAS-ID state had lower radiographic progression than patients with higher disease activity at 2 and 4-years suggesting a potential relationship between ASDAS state and structural progression in patients with AS. Further confirmation is needed in larger prospective studies. <h3>References</h3> [1] Smolen JS, et al. Ann Rheum Dis. 2018;77:3-17. [2] Poddubnyy D, et al. Ann Rheum Dis. 2014;73:422. [3] Braun J, et al. Rheumatology (Oxford)2018. Doi: 10.1093/rheumatology/key375. <h3>Disclosure of Interests</h3> Xenofon Baraliakos Grant/research support from: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Centocor, Chugai, Janssen, MSD, Novartis, Pfizer Inc, Roche and UCB, Grant/research support from: AbbVie, Pfizer, Merck Sharp &amp; Dohme, UCB Pharma, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Janssen Biologics, Novartis, Pfizer, UCB Pharma, Galapagos, Speakers bureau: AbbVie, Chugai, Janssen, Novartis, Pfizer, UCB Pharma, Helena Marzo-Ortega Grant/research support from: Janssen, Novartis and Pfizer, Consultant for: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Speakers bureau: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Filip van den Bosch Consultant for: AbbVie, BMS, Galapagos, Janssen, Lilly, Merck, Novartis, Pfizer and UCB, Speakers bureau: AbbVie, BMS, Janssen, Lilly, Merck, Novartis, Pfizer and UCB., Atul Deodhar Grant/research support from: AbbVie, Amgen, Eli Lilly, GSK, Janssen, Novartis, Pfizer, and UCB, Consultant for: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Erhard Quebe-Fehling Shareholder of: Novartis, Employee of: Novartis, Eumorphia Maria Delicha Employee of: Novartis, Zsolts Talloczy Shareholder of: Novartis, Employee of: Novartis, Corine Gaillez Shareholder of: Novartis, BMS, Employee of: Novartis