RECAPTURE RATES WITH IXEKIZUMAB AFTER WITHDRAWAL OF THERAPY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS AT WEEK 104 FROM A RANDOMIZED PLACEBO-CONTROLLED WITHDRAWAL STUDY
Authors: Rebecca Bolce et al.
There is increasing evidence that treatment with biologics can be reduced in patients that have achieved low disease activity. The authors describe the results of a phase III randomized extension trial (COAST-Y) of patients with AS or nr-axSpA treated with ixekizumab, that included a randomized withdrawal and retreatment phase. Patients that achieved inactive disease or low disease activity at week 24 of treatment with ixekizumab, were randomized to continuation or withdrawal of ixekizumab for up to week 104. Patients that had a disease flare were restarted on ixekizumab. The proportion of patients that regained ASDAS low disease activity (LDA) or inactive disease (ID) was analyzed. 155 patients entered the study. 64% of the patients that withdrew ixekizumab experienced a flare until week 104. Of the patients that flared 14% recaptured LDA spontaneously and 82% after restarting ixekizumab. 68% meet the criteria of ID.
This study shows that the large majority of patients that pause or discontinue IL-17 inhibitor therapy with ixekizumab respond well if therapy is restarted and recapture low disease activity. This is reassuring for patients that have to pause treatment e.g. because of surgery.