Safety of secukinumab for the treatment of active ankylosing spondylitis

ABSTRACT

Introduction: Secukinumab is a fully human monoclonal antibody which targets and neutralizes interleukin (IL)-17A, a cytokine that plays an important role in the pathophysiology of ankylosing spondylitis (AS). Secukinumab is the first IL-17A inhibitor approved for the treatment of AS.

Areas covered: This paper aimed to evaluate the role of IL-17 in human beings, and the blocking of this cytokine with secukinumab while reviewing its efficacy and safety in the treatment of AS from data of MEASURE clinical trials.

Expert opinion: MEASURE clinical trials showed efficacy and safety of secukinumab in patients with AS. Mild infections were the most frequent adverse event observed. Mucocutaneous candidiasis was a relatively common side effect due to the role of IL-17A in mucocutaneous defense against extracellular organisms. Secukinumab remained generally well tolerated over the longer-term. The combination of efficacy and safety makes secukinumab a good option of treatment for patients with AS refractory to non-steroidal anti-inflammatory drugs.

KEYWORDS:

• Secukinumab
• interleukin-17A
• ankylosing spondylitis
• safety

Article highlights

• IL-17 is a cytokine which plays an important role in the pathophysiology of AS.

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

• Data from clinical trials showed a high anti-inflammatory potential of secukinumab in AS.

• Secukinumab demonstrated efficacy over placebo even in TNFi inadequate responders.

• The safety profile of secukinumab seems acceptable.

Drug summary

Drug name: secukinumab

Phase: approved in over 30 countries.

Indications: Active ankylosing spondylitis in adults who have not responded adequately to conventional treatment. Active non-radiographic axial spondyloarthritis with objective signs of inflammation as indicated by elevated reactive protein-C and/or magnetic resonance imaging evidence in adults who have not responded adequately to non-steroidal anti-inflammatory drugs. Patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy. Patients with active psoriatic arthritis.

Mechanism of action: Human anti-IL17A G 1k monoclonal antibody that selectively targets and neutralizes IL-17A

Route of administration: Subcutaneous

Chemical structure: C₆₅₈₄H₁₀₁₃₄N₁₇₅₄O₂₀₄₂S₄₄

Pivotal trials: MEASURE 1 [29, 30, 35], MEASURE 2 [29, 34], MEASURE 3 [31, 32], and MEASURE 4 [33]

Declaration of interest

R Blanco has received grants/research supports from Abbvie, MSD, and Roche, and had consultation fees/participation in company-sponsored speaker´s bureau from Abbvie, Pfizer, Roche, Bristol Myers, Janssen, and MSD. 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.

Reviewer disclosures

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

Additional information

Funding

This paper was not funded.