In the treatment of radiographic axial spondyloarthritis (r-axSpA), the 2-year incidence of spinal radiographic progression is low and not different between secukinumab and adalimumab biosimilar, as shown in the phase IIIb study SURPASS study.
SURPASS included 859 biologic-naïve patients (mean age 42.1 years, 78.5 percent male) with active r-axSpA who were at high risk of radiographic progression (defined as having high-sensitivity C-reactive protein (hsCRP) ≥5 mg/L and/or ≥1 syndesmophyte[s] on spinal radiographs). These patients were randomly assigned to treatment with secukinumab 150 mg (n=287), secukinumab 300 mg (n=286), or adalimumab biosimilar (n=286).
The primary endpoint was the proportion of patients with no radiographic progression (change from baseline [CFB] in modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS] ≤0.5) on secukinumab versus adalimumab biosimilar at week 104. Researchers also evaluated mean CFB-mSASSS, proportion of patients with ≥1 syndesmophyte(s) at baseline with no new syndesmophytes(s), and safety.
At baseline, the average mSASSS was 16.6, BASDAI was 7.1, and hsCRP was 20.4 mg/L. Most patients (73.0 percent) had ≥1 syndesmophyte(s). At week 104, the primary endpoint was achieved in 66.1 percent of patients on secukinumab 150 mg, 66.9 percent on secukinumab 300 mg, and 65.6 percent on adalimumab biosimilar, with no significant differences observed.
The mean CFB-mSASSS was 0.54, 0.55, and 0.72 in secukinumab 150 mg, 300 mg, and adalimumab biosimilar groups, respectively. The corresponding proportions of patients who had ≥1 syndesmophyte(s) at baseline and did not develop any new syndesmophyte(s) by week 104 were 56.9 percent, 53.8 percent, and 53.3 percent, respectively.
No new safety concerns were identified.