EFFECT OF IXEKIZUMAB TREATMENT ON MRI STRUCTURAL LESIONS IN THE SACROILIAC JOINTS OF PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS; A POST-HOC ANALYSIS OF A PLACEBO AND ACTIVE CONTROLLED RCT
Authors: Walter P. Maksymowych et al.
Data from real-world registries have suggested that treatment with TNF-inhibitors reduce radiographic progression in axSpA. There are no randomized placebo controlled trials of long duration to confirm these effects for the biologics licensed for the treatment of axSpA. This study aimed to assess structural changes in the sacroiliac joints of patients with r-axSpA treated with Ixekizumab or Adalimumab or placebo. MRI imaging data at baseline and week 16 were analyzed from a phase III randomized trial (COAST V). The Spondyloarthritis Research Consortium of Canada Sacroiliac Structural Score (SPARCC SSS) for erosion and backfill was measured.
The erosion score was significantly reduced in patients treated with Ixekizumab and the backfill score was increased at 16 weeks. Similar, numerically lower effects were seen in the adalimumab treated group, whereas the erosion score slightly increased in the placebo group. These results suggest tissue repair in the sacroiliac joints in patients with Ixekizumab treatment.
This elegant imaging study, using an MRI based score to measure erosions and repair, shows that within a relatively short period of time repair of destructive changes in the sacroiliac joints can be seen under therapy with Ixekizumab and the active control Adalimumab. This study supports an inhibitory effect of biologic drugs on radiographic progression in axSpA.