ABSTRACT
Introduction: Ankylosing spondylitis (AS) is a chronic immune-mediated disease characterised by inflammation and new bone formation in the axial skeleton. Current therapeutic strategies include non-steroidal anti-inflammatory drugs, local glucocorticoids and tumour necrosis factor inhibitors. However, an unmet need exists for more treatment options particularly for patients who become unresponsive to and/or cannot tolerate these medications. Interleukin (IL)-17A, a proinflammatory cytokine that plays a crucial role in the pathogenesis of AS, has emerged as a promising target in the search for new therapies. Recently, the IL-17A inhibitor secukinumab has demonstrated significant efficacy in reducing the signs and symptoms of AS.
Areas covered: Inhibition of IL-17A by secukinumab represents a novel therapeutic approach in the management of AS. Secukinumab selectively targets IL-17A and inhibits its interaction with the IL-17 receptor, thus inhibiting the release of proinflammatory cytokines, chemokines and mediators of tissue damage. Here we provide an overview of the pharmacology, clinical efficacy and safety of secukinumab in the treatment of AS.
Expert opinion: Secukinumab has shown strong efficacy and a good safety profile in several immune-mediated diseases including psoriasis, psoriatic arthritis and AS. Secukinumab recently received Food and Drug Administration (FDA) and European Union (EU) approval for the treatment of adult patients with active AS and can be expected to become an established therapy for AS over the next 5 years.
Box 1. Drug summary.
Acknowledgements
The authors would like to thank John Gallagher, a medical consultant for Novartis Pharma AG. Editorial assistance was provided by Rugina Ali and Ben Drever, medical writers from Seren Communications, an Ashfield Company, part of UDG Healthcare plc, the funding for which was provided by Novartis.
Declaration of interest
Dr. Braun has received honoraria for talks, advisory boards, paid consultancies and grants for studies from Abbvie (Abbott), Amgen, Biogen, Boehringer, BMS, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Hospira, Janssen, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB.
Dr. Baraliakos has received paid consultancies and grants for studies from Abbvie (Abbott), Pfizer (Wyeth), MSD (Schering-Plough), UCB, Novartis, Roche, and Chugai.
Dr. Kiltz has received paid consultancies and grant for Abbvie (Abbott), Pfizer (Wyeth), MSD (Schering-Plough), UCB, Novartis, Roche, and Chugai. 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Notice of correction
Please note that , section 5.2, , and reference Citation86 have been corrected in the online issue since the article was first published online (15 April 2016).