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Ixekizumab continues to show benefit for nr-axSpA

Audrey Abella
20 Jul 2020

Use of the monoclonal antibody ixekizumab led to improvements in symptoms, work productivity, and overall functioning and health in patients with nonradiographic axial spondyloarthritis (nr-axSpA), subgroup results of the phase III COAST-X trial have shown.

A total of 303 bDMARD*-naïve participants were randomized 1:1:1 to receive ixekizumab 80 mg Q2W or Q4W, or placebo, for 52 weeks. If disease activity persists by week 16, participants may switch to open-label ixekizumab Q2W or a tumour necrosis factor inhibitor.

 

Common symptoms

At week 16, compared with placebo, both ixekizumab regimens led to significant improvements in spinal pain (–2.59 vs –1.45; p≤0.001 [Q2W] and –2.35 vs –1.45; p<0.05 [Q4W]) and BASDAI** stiffness (–2.89  vs –1.44; p≤0.001 and –2.44 vs –1.44; p<0.05, respectively). The Q4W regimen also improved fatigue (–2.1 vs –1.4), while the Q2W regimen improved spinal pain at night (–2.79 vs –1.71; p<0.05 for both). [EULAR 2020, abstract FRI0286]

Although both ixekizumab regimens improved stiffness by week 52 (–3.48 vs –1.94; p≤0.001 [Q2W] and –3.15 vs –1.94; p<0.05 [Q4W]), the Q2W regimen fared better at this time given the additional improvements in spinal pain (–3.32 vs –2.29) and spinal pain at night (–3.58 vs –2.25; p<0.05 for both).

Compared with placebo, ixekizumab use also led to significant improvements in PtGA*** at week 16 (–2.64 vs –1.30; p≤0.001 [Q2W] and –2.32 vs –1.30; p<0.05 [Q4W]) and week 52 (–3.30 vs –1.81; p<0.05 [Q2W]).

 

Work productivity

Patients on ixekizumab Q4W had significantly greater improvement than those on placebo in terms of activity impairment and presenteeism (p<0.01 for both), as well as overall work impairment, at week 16 (p<0.05). Week 52 saw similar improvements in the same parameters with the same ixekizumab regimen (p<0.01 for all). [EULAR 2020, abstract THU0384]

The Q2W ixekizumab regimen also trumped placebo in terms of activity impairment at weeks 16 and 52 (p<0.01 for both).

 

Overall function, health

Week 16 saw significantly more ixekizumab vs placebo recipients achieving ASAS HI# scores ≥3 (Q2W) and ≤5 (Q4W; p<0.05 for both). [EULAR 2020, abstract FRI0278]

From week 36–52, both ixekizumab regimens outshined placebo in terms of the percentage of participants achieving ASAS HI scores ≥3 (34 percent vs 19 percent [Q2W] and 33 percent vs 19 percent [Q4W]; p<0.05 for both) and ≤5 (35 percent vs 13 percent; p<0.001 [Q2W] and 27 percent vs 13 percent; p<0.05 [Q4W]).

“The smallest detectable change [in ASAS HI] was calculated at 3,” said the researchers. The achieved ASAS HI ≥3 scores were “clinically meaningful”, while the ASAS HI ≤5 scores signified “a good health state”, they noted.

Nr-axSpA greatly impairs health-related quality of life, including work productivity, of afflicted individuals. [Clin Exp Rheumatol 2016;34:975-983; Lancet 2018;392:2441-2451; Arthritis Rheumatol 2019;71:599-611] Collectively, the improvements seen with ixekizumab signify the achievement of good overall functioning and health status among adults with nr-axSpA, further boosting the previously reported therapeutic potential of the study drug. [Lancet 2020;395:53-64]

 

 

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Most Read Articles
Stephen Padilla, Yesterday
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
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