Secukinumab for the Treatment of Ankylosing Spondylitis: A Systematic Review of Efficacy and Safety

Abstract

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton. Secukinumab, a monoclonal antibody targeting interleukin-17A (IL-17A), is a biologic therapy approved for AS. This review assesses its efficacy and safety.

Methods: A search of MEDLINE and Embase was conducted for placebo-controlled RCTs of secukinumab in patients with active AS. The primary outcome was the ASAS20 (Assessment of SpondyloArthritis international Society 20%) response rate.

Results: The meta-analysis of five RCTs demonstrated that secukinumab treatment resulted in significantly higher ASAS20 and ASAS40 response rates compared to placebo. Improvements were rapid and sustained, with significant benefits also seen in physical function, quality of life, and spinal mobility. An increased risk of non-serious mucocutaneous candidiasis was noted.

Discussion: The IL-17A pathway is central to the pathogenesis of AS. Secukinumab's targeted inhibition of this pathway provides a highly effective treatment option, particularly for patients with an inadequate response to anti-TNF therapy.

Conclusion: Secukinumab is a highly effective and generally well-tolerated treatment for improving the signs and symptoms of ankylosing spondylitis.