Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.

Ixekizumab delivers rapid improvements in active radiographic axial spondyloarthritis

Jairia Dela Cruz
6 days ago

Ixekizumab is safe and effective in the treatment of patients with active radiographic axial spondyloarthritis (r‐axSpA) and previously inadequate response or intolerance to tumour necrosis factor inhibitors (TNFIs), producing rapid and significant improvements in the signs and symptoms, according to the 16-week results of the phase III COAST-W trial.

“The current results support ixekizumab as a treatment option in patients with r-axSpA and prior inadequate response or intolerance to TNFI,” the authors said.

COAST-W randomized 316 patients to receive placebo (n=104) or 80‐mg subcutaneous ixekizumab every 2 (IXEQ2W; n=98) or 4 (IXEQ4W; n=114) weeks, with the starting dose being 80 or 160 mg. Significantly more patients in the two ixekizumab arms achieved the primary endpoint of ASAS40 response (Assessment of SpondyloArthritis International Society 40 percent) at week 16 (30.6 percent and 25.4 percent vs 12.5 percent; p=0.003 or p=0.017, respectively). [Arthritis Rheumatol 2018;doi:10.1002/art.40753]

The response with ixekizumab was seen as early as the first week of treatment, the authors noted.

“Despite the greater exposure with the IXEQ2W regimen, IXEQ2W did not show a clinically meaningful incremental increase in observed efficacy relative to the IXEQ4W regimen. Similarly, the week 0 starting dose of 160 mg did not reveal a clinically meaningful incremental improvement in week 16 response rates relative to the 80-mg starting dose for either ixekizumab regimen,” they added.

Aside from response, other endpoints such as disease activity, function, quality of life and spinal magnetic resonance imaging (MRI) inflammation showed superior improvements with both ixekizumab regimens vs placebo.

The drug showed an acceptable safety profile in the present patient population with longstanding and very active disease. Treatment-emergent adverse events (AEs) occurred more frequently with ixekizumab than with placebo, driven by upper respiratory tract infections and injection site reactions. Serious AEs occurred at similar rates across ixekizumab and placebo arms.

“COAST-W is the first placebo-controlled trial to generate spinal MRI data in a TNFI intolerant or inadequate responder population,” the authors pointed out. “Despite baseline levels of spinal inflammation being relatively low, thereby hampering ability to improve, a statistically significant and objective effect on spinal inflammation was observed for IXEQ2W and IXEQ4W … which was supported by parallel improvements in CRP.”

“Conversely, the current dataset is limited to a 16-week treatment period. Longer-term data, which are being collected through 1 year of treatment in the present trial, as well as during an optional 2-year extension trial, will further inform on the long-term efficacy and safety of ixekizumab,” they added.

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.