Emerging drugs for the treatment of axial spondyloarthritis

ABSTRACT

Introduction: The treatment of axial spondyloarthritis(axSpA) has been for nearly 15 years constricted to non-steroidal antirheumatic drugs and TNFα inhibitors. With the approval of secukinumab, a drug targeting the interleukin(IL)-17 axis became available. Nonetheless, an unmet need for further emerging therapeutic options remains.

Areas covered: This review summarizes the recent and ongoing clinical trials with novel drugs in axSpA. Besides secukinumab, further therapeutics directed against the IL-17A (e.g. ixekizumab) as well as the dual IL-17A and F inhibitor bimekizumab and the IL-17RA antibody brodalumab are in development. Furthermore, several drugs targeting the IL-12/-23 axis are being evaluated. Pan-JAK and JAK-1 inhibitors might offer another effective mode of action.

Expert opinion: The number of treatment options in axSpA is likely to be further extended in the coming years. Data of ongoing studies are needed to prove the efficacy of drugs directed against the IL-12/-23 axis as well as of JAK inhibition, whilst targeting the IL-17 axis was shown to be as effective as TNF inhibition by indirect comparison. There is an emerging need for trials aiming at identification of optimal treatment strategies in the scope of the treat-to-target concept in axSpA.

KEYWORDS:

• Axial spondyloarthritis
• treatment
• TNF
• interleukin-12
• interleukin-17
• interleukin-23
• JAK

Declaration of interest

J Rademacher has received grant/research support from AbbVie, and has been a speaker and consultant for Novartis. D Poddubnyy has received grant/ research support from AbbVie, Merck Sharp & Dohme, and Novartis, has been a speaker/ consultant for AbbVie, Celgene, Bristol-Myers Squibb, Boehringer Ingelheim, Janssen, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche and UCB Pharma. 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.

Additional information

Funding

This paper was not funded