According to Ankylosing Spondylitis News, data from the Phase 3 PREVENT clinical trial highlights Cosentyx (secukinumab) as an effective treatment for patients with non-radiographic axial spondyloarthritis (nr-axSpA), as well as ankylosing spondylitis. The PREVENT trial sought to understand whether Cosentyx could cause continued symptom reduction over a long-term period. Based on the positive data, Cosentyx was recently FDA-approved for patients with nr-axSpA. You can read the full study results in Arthritis & Rheumatology.

Study Findings

In chronic inflammatory diseases, pro-inflammatory immune proteins (interleukins) often play a role. In this case, researchers wondered if inhibiting interleukin-17a (IL-17a) would reduce inflammation in patients with nr-axSpA.

Prior to the PREVENT trial, researchers examined the efficacy of Cosentyx for patients with ankylosing spondylitis in the MEASURE 1 and MEASURE 2 clinical trials. However, researchers wanted to officially determine the therapeutic value for patients with nr-axSpA.

The PREVENT trial enrolled 555 participants, a majority of which were male. The average participant age was 39. Prior to enrollment, patients tried at least 2 NSAIDs for at least one month. However, most patients previously did not try any TNF inhibitors. Ultimately, researchers wanted to see whether Cosentyx provided a significant benefit to patients as compared to a placebo. To determine this, they utilized the Assessment of Spondyloarthritis International Society (ASAS) 40 response criteria after 4 months and 1 year. These criteria measure inflammation, pain, function, and quality of life (QOL).

Cosentyx significantly improved symptom reduction (fatigue, spine and joint pain, swelling, and stiffness) in patients when compared to a placebo. Additionally, Cosentyx significantly improved quality of life. The therapy was generally well-tolerated. Side effects included uveitis (eye inflammation) and inflammatory bowel disease.

Non-Radiographic Axial Spondyloarthritis (nr-axSpA)

Both non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis exist under the umbrella of spondyloarthritis, a group of conditions characterized by inflammatory arthritis, particularly in the spine. According to Creaky Joints:

Non-radiographic means the disease causes symptoms, but there’s no visible damage on X-rays, the way there is with Ankylosing Spondylitis. Axial refers to joints that the disease primarily affects: the spine, chest, and hip bone; and spondyloarthritis is a family of inflammatory arthritis that affects the joints and entheses, which are tissues between the bone and ligament or tendons.

Patients with nr-axSpA usually experience symptoms before the age of 40. These include:

• Back pain and stiffness, especially in the morning. However, the back pain may be intense enough to wake you up in the middle of the night.
• Pain reduction when moving around or becoming active
• Psoriatic arthritis and plaques
• Diarrhea
• Joint pain and inflammation
• Uveitis (eye inflammation)

Learn more about nr-axSpA.