ASAS-EULAR Recommendations for the Management of Axial Spondyloarthritis: 2022 Update

Ann Rheum Dis 2022; online ahead of print doi:10.1136/ard-2022-223296

Since the last update in 2016, more data have become available on existing treatment options for axSpA, and particularly on IL-17i. The increasing availability of more drugs and with different modes of action raises questions around their positioning in the treatment pathway. This review sought to update the 2016 recommendations with newly available evidence.

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October 2022

This study explored the clinical characteristics, outcomes, and time to onset of the four main toxicities of secukinumab with hypersensitivity identified as the most common toxicity.

In this latest investigation into ixekizumab more patients achieved targets assessed by mCPDAI and DAPSA than with other composites. This study assess’ the concordance and variability in performance of the composite measures in patients with PsA, as well as to provide greater granularity to the frequency and severity of residual symptoms in patients who achieve treatment targets.

Ixekizumab (IXE)-treated patients achieved significantly greater simultaneous PASI100 and ACR50 responses through W52 versus adalimumab (ADA)-treated, confirming IXE as an efficacious and safe treatment. This study investigated the efficacy and safety of IXE and ADA in the subgroup of patients with PsA and moderate-to-severe PsO through W52.

The present analysis demonstrated that patients continuously treated with IXE were less likely to experience flare compared with patients receiving placebo. The aim of this study was to evaluate the recapture of response with open-label IXE retreatment at week 104 in patients with axSpA who flared after withdrawal of IXE therapy.

September 2022

This study highlighted improvements in disease activity, function and quality of life were achieved early on into treatment and were sustained through 116 weeks of IXE therapy for patients with r-axSpA and nr-axSpA. In this study investigators aimed to report the long-term efficacy and safety results for patients treated with ixekizumab for up to 116 weeks.

In the latest study by Brunner, et al. secukinumab demonstrated efficacy and safety in the JIA categories of ERA and JPsA. This phase 3 study aimed to demonstrate the efficacy and safety of secukinumab in patients with active ERA and JPsA.

August 2022

Bimekizumab is associated with sustained, long-term efficacy in r-axSpA patinets across three years of treatment. In coming to this conclusion, investigators sought to assess the long-term safety, tolerability, and efficacy of bimekizumab in active r-axSpA.

In this investigation bimekizumab was associated with a sustained ACR50 improvement. This was highlighted following the attempt to describe the long-term safety, tolerability, and efficacy of up to three years of bimekizumab treatment in PsA patients

Secukinumab improves the burden of heel enthesitis as assessed by patient and physician reported outcomes in patients with active SpA refractory to standard treatment. In coming to this conclusion, the ACHILLES trial aimed to demonstrate the efficacy of secukinumab on Achilles’ tendon enthesitis in SpA patients.