Anti-IL-17 monoclonal antibodies for the treatment of ankylosing spondylitis

ABSTRACT

Introduction: Ankylosing spondylitis is the prototype of spondyloarthritis, a chronic inflammatory disease involving mainly the axial skeleton. The treatment strategy was, until now, restricted to NSAIDs and anti-TNF agents. Targeting Interleukin 17 is an emerging option with a currently available biologic agent, secukinumab.

Areas covered: This paper reviews the available data published on secukinumab (and other anti-IL-17 agents) in ankylosing spondylitis, evaluating the effect on clinical outcomes as well as radiological progression and extra articular manifestations and safety.

Expert opinion: Secukinumab represents the first anti-IL-17A agent available for the treatment of ankylosing spondylitis, with evidence of efficacy upon signs and symptoms of the disease, even after anti-TNF failure, and acceptable safety profile.

KEYWORDS:

• Ankylosing spondylitis
• Interleukin 17
• ixekizumab
• secukinumab
• spondyloarthritis

Article highlights

• IL-17 is a cytokine implicated in the pathophysiology of ankylosing spondylitis

• Secukinumab is a monoclonal antibody directed against IL-17A

• Clinical results of the phase II and III controlled studies with secukinumab represent a proof of concept

• Secukinumab (and ixekizumab) demonstrated efficacy over placebo even in anti-TNF inadequate responders

• Safety profile of secukinumab and other anti-IL-17 agents seems acceptable

• Other modalities of IL-17 blockade are under evaluation.

Declaration of interest

D Wendling is the French national coordinator of the MEASURE 1 study; has received speaking fees from AbbVie, BMS, MSD, Pfizer, Roche Chugai, Amgen, Nordic Pharma, UCB, SOBI, Sanofi Aventis, Novartis, Janssen, Celgene, Hospira, Lilly, Sandoz, Grunenthal; and received hospitality from: Abbvie, Pfizer, Roche Chugai, MSD, UCB, Mylan. F Verhoeven has received speaking fees from Expanscience, Novartis, MSD, Celgene and Amgen; and hospitality from Roche Chugai, Medac, Nordic Pharma, Novartis, Abbvie, BMS. C Prati has received grants from Pfizer; acted as a speaker for Chugai, Lilly, Sanofi and Novartis; and received hospitality from Sanofi, UCB, Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.