Oral JAK Inhibitor Promising in Ankylosing Spondylitis

“At week 12, there was clear dose-response in all clinical outcome measures,” said Dr van der Heijde.

There was improvement in MRI Spondyloarthritis Research Consortium of Canada (SPARCC) scores from baseline to week 12 with tofacitinib, particularly in the 5 mg and 10 mg groups; the change was minimal in the 2 mg group. In the placebo group, there was almost no change in SPARCC scores over the study period.

Between the 5 mg and 10 mg groups, the differences in improvement in SPARCC sacroiliac joint and spine scores were minimal, as was the difference in clinical efficacy, Dr van der Heijde explained.

There was no difference in the safety profile between any of the tofacitinib groups and the placebo group.

Although some dose-dependent changes in laboratory outcomes were seen in the tofacitinib groups, levels had returned to baseline by the end of the study, and very few patients in the tofacitinib groups discontinued treatment.

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“We now have positive data on at least one JAK inhibitor in this disease,” said Dr van der Heijde.

New medications for the treatment of most rheumatic diseases are always needed. “We never have enough,” said Juergen Braun, MD, from Rheumazentrum Ruhrgebiet in Herne, Germany.

Interleukin-17A Inhibition

During the same session, Dr Braun presented first results from the MEASURE 1 trial, evaluating the long-term effects of interleukin-17A inhibition with secukinumab in patients with ankylosing spondylitis.

Secukinumab was administered in one of two doses in the trial — 75 mg and 150 mg — but there were no major differences in radiographic results between the groups, so the researchers pooled the data.

“The mean change in the modified Stoke Ankylosing Spondylitis Spine Score at 104 weeks was only 0.30 in the group overall, although radiographic changes were more pronounced in males, in patients with syndesmophytes at baseline, and in those with an elevated C-reactive protein,” Dr Braun reported.

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