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Immune therapy shows promising results in ankylosing spondylitis trial

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New research published in the journal Arthritis & Rheumatology has identified a potential new treatment option for patients with ankylosing spondylitis (AS).

AS is a long-term condition in which the spine and other areas of the body become inflamed. Symptoms include back pain and stiffness and inflammation of the joints (arthritis) in other parts of the body, such as the hips and knees.

Although there is no cure for AS, and it’s not possible to reverse the damage caused by the condition, treatments are available to relieve the symptoms and help prevent or delay its progression. However, around 30-40% of patients with AS do not achieve adequate disease control or symptom relief from anti-tumour necrosis factor (TNF) medication, the currently recommended treatment. In addition, some patients may not be able to have this treatment due to contraindications.

The cytokine IL-17 is thought to play a role in the development of AS, and IL-17 inhibitors are effective in some patients, but until now they have not been evaluated exclusively in patients who have not experienced symptom relief with TNF inhibitors, journal publisher Wiley reports.

In the new study, Dr Atul Deodhar of Oregon Health & Science University and his colleagues conducted a randomised, double-blind, placebo-controlled Phase 3 clinical trial of ixekizumab, a high-affinity monoclonal antibody that selectively targets IL-17A, in patients with AS who experienced a previous inadequate response or intolerance to TNF inhibitors.

Participants who were given ixekizumab every two weeks or every four weeks showed statistically significant improvements in disease activity, function, quality of life and spinal inflammation compared with those in the placebo group.

“Many people with this chronic, debilitating disease are still searching for an effective treatment,” Dr Deodhar said. “These positive results provide support for ixekizumab as a potential treatment option for patients with AS, including those who have had an inadequate response to treatment with TNF inhibitors, a difficult-to-treat population.”