Ixekizumab, an interleukin-17A antagonist in the treatment of ankylosing spondylitis or radiographic axial spondyloarthritis in patients previously untreated with biological disease-modifying anti-rheumatic drugs (COAST-V):16 week results of a phase 3 RCT -

Ixekizumab, an interleukin-17A antagonist in the treatment of ankylosing spondylitis or radiographic axial spondyloarthritis in patients previously untreated with biological disease-modifying anti-rheumatic drugs (COAST-V):16 week results of a phase 3 RCT
Information type: Randomised controlled trials
Source: Lancet Public Health
Specialities: Musculo-skeletal disorders
Summary
RCT (n=341) found at week 16, more patients achieved ASAS40 with ixekizumab (IX) 2-weekly (43 [52%]; p<0·0001), 4-weekly (39 [48%]; p<0·0001), and adalimumab (32 [36%]; p=0·0053) compared with placebo (16 [18%]). Safety profile was consistent with previous indications of IX.
UKMi comment
A commentary notes that it is good to have another alternative for the management of patients with radiographic axial spondyloarthritis and it will be interesting to see anti-IL-17 data in non-radiographic axial spondyloarthritis, and learn more about the relative effect of IL-17 inhibition in patients with and without an increased C-reactive protein concentration at baseline. It adds the expectation is that the efficacy of ixekizumab will be sustained over several years with relatively high retention and limited radiographic progression, but acknowledges there is still an unmet need for head-to-head and strategy trials to provide better and scientifically based care to patients with axial spondyloarthritis.
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