Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis

Estándar

Dominique Baeten, M.D., Joachim Sieper, M.D., Jürgen Braun, M.D., Xenofon Baraliakos, M.D., Maxime Dougados, M.D., Paul Emery, F.R.C.P., Atul Deodhar, M.D., Brian Porter, M.D., Ph.D., M.P.H., Ruvie Martin, Ph.D., Mats Andersson, M.Sc., Shephard Mpofu, M.D., and Hanno B. Richards, M.D. for the MEASURE 1 and MEASURE 2 Study Groups
N Engl J Med 2015; 373:2534-2548December 24, 2015DOI: 10.1056/NEJMoa1505066BACKGROUND
Secukinumab is an anti–interleukin-17A monoclonal antibody that has been shown to control the symptoms of ankylosing spondylitis in a phase 2 trial. We conducted two phase 3 trials of secukinumab in patients with active ankylosing spondylitis.
METHODS
In two double-blind trials, we randomly assigned patients to receive secukinumab or placebo. In MEASURE 1, a total of 371 patients received intravenous secukinumab (10 mg per kilogram of body weight) or matched placebo at weeks 0, 2, and 4, followed by subcutaneous secukinumab (150 mg or 75 mg) or matched placebo every 4 weeks starting at week 8. In MEASURE 2, a total of 219 patients received subcutaneous secukinumab (150 mg or 75 mg) or matched placebo at baseline; at weeks 1, 2, and 3; and every 4 weeks starting at week 4. At week 16, patients in the placebo group were randomly reassigned to subcutaneous secukinumab at a dose of 150 mg or 75 mg. The primary end point was the proportion of patients with at least 20% improvement in Assessment of Spondyloarthritis International Society (ASAS20) response criteria at week 16.

 

RESULTS
In MEASURE 1, the ASAS20 response rates at week 16 were 61%, 60%, and 29% for subcutaneous secukinumab at doses of 150 mg and 75 mg and for placebo, respectively (P

CONCLUSIONS
Secukinumab at a subcutaneous dose of 150 mg, with either subcutaneous or intravenous loading, provided significant reductions in the signs and symptoms of ankylosing spondylitis at week 16. Secukinumab at a subcutaneous dose of 75 mg resulted in significant improvement only with a higher intravenous loading dose. (Funded by Novartis Pharma; ClinicalTrials.gov numbers,

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