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Abstract Number: 1529

Secukinumab Demonstrates Consistent Safety over Long-Term Exposure (up to 3 years) in Patients with Active Ankylosing Spondylitis: Pooled Analysis of Three Phase 3 Trials

Atul A. Deodhar1, Xenofon Baraliakos2, Helena Marzo-Ortega3, Joachim Sieper4, Mats Andersson5, Brian Porter6 and Todd Fox5, 1Oregon Health & Science University, Portland, OR, 2Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany, 3NIHR LBRC, LTHT and LIRMM, UoL, Leeds, United Kingdom, 4Charité University Medicine Berlin, Berlin, Germany, 5Novartis Pharma AG, Basel, Switzerland, 6Novartis Pharmaceuticals Corporation, East Hanover, NJ

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Ankylosing spondylitis (AS), Biologics, interleukins (IL) and safety

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Session Information

Date: Monday, November 6, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Secukinumab has demonstrated a consistent and reliable safety profile in three Phase 3 studies in ankylosing spondylitis (AS): MEASURE 1 (NCT01358175), MEASURE 2 (NCT01649375), and MEASURE 3 (NCT02008916).1–4 Here, we report long-term (up to 3 years) pooled safety and tolerability data for secukinumab from these three studies (data cut-off: June 25, 2016).

Methods: Overall, 371, 219, and 226 patients with active AS were randomized in MEASURE 1, MEASURE 2, and MEASURE 3, respectively. Study design, efficacy, and safety results of these studies have been reported elsewhere.4,5 Secukinumab doses differed in the studies and included intravenous 10 mg/kg or subcutaneous (s.c.; 75–300 mg) multi-dose loading, followed by s.c. maintenance dosing (75, 150, or 300 mg). Data collected up to the last patient performing the Week (Wk) 156 visit in MEASURE 1, the Wk 104 visit in MEASURE 2, and the Wk 52 visit in MEASURE 3 were pooled at the individual patient level. Exposure-adjusted incidence rates were calculated to account for differences in treatment exposure, and safety analyses included all patients who received ≥1 dose of secukinumab.

Results: A total of 794 patients were included in the analysis (representing 1706.3 patient-years of exposure). The exposure-adjusted incidence rates of adverse events (AEs) and serious AEs with secukinumab across the entire safety period were 146.8 and 6.2 per 100 patient-years, respectively. Nasopharyngitis, diarrhea, headache and upper respiratory tract infections were the most frequently reported AEs (Table). The incidences of serious infections, Candida infections, uveitis, and inflammatory bowel disease were low and consistent with previous reports over shorter exposure periods1 (Table). No cases of suicidal ideation or depression were reported.

Conclusion: Secukinumab was well tolerated during long term treatment (representing 1706.3 patient-years of exposure) in patients with AS, with a favorable safety profile consistent with previous reports, with no new safety signals.

References: 1. Braun J, et al. Ann Rheum Dis. 2017;76:1070-7; 2. Baraliakos X, et al. Clin Exp Rheumatol. 2017; 3. Marzo-Ortega H, et al. Arthritis Care Res (Hoboken). 2017;doi: 10.1002/acr.23233; 4. Kivitz A, et al. XIX PANLAR 2016, Panamá City, Panama. Poster No. P-081; 5. Baeten D, et al. N Engl J Med 2015;373:2534–48.

Table: Summary of pooled safety across 3 AS studies (Entire safety period)

Any secukinumab dose

N=794

Total exposure, patient-years

1706.3

Minimum–maximum exposure (days)

1–1530

Death, n (%)

3 (0.4)

EAIR per 100 Patient-years (95% Cl)

Any AE

146.8 (135.9, 158.4)

Any SAE

6.2 (5.0, 7.6)

Frequent AEs^

Nasopharyngitis

12.3 (10.5, 14.3)

Headache

6.0 (4.9, 7.4)

Diarrhoea

5.7 (4.6, 7.1)

Upper respiratory tract infections

5.1 (4.1, 6.4)

AEs of special interest

Serious infections and infestations

1.1 (0.7, 1.8)

Candida infections

0.7 (0.4, 1.2)

Inflammatory bowel disease

0.7 (0.4, 1.2)

Crohn’s disease1

0.5 (0.2, 0.9)

Ulcerative colitis

0.2 (0.1, 0.6)

Uveitis2

1.3 (0.8, 2.0)

MACE

0.7 (0.4, 1.2)

^Adverse events that occurred in Any secukinumab group with an EAIR >5 during the entire safety period. 1Includes 8 cases of Crohn’s disease, of which 5 were de novo and 3 were flares in patients with a history of Crohn’s disease at baseline. 2All cases of uveitis (n=22) were flares in patients with a history of uveitis at baseline. AE, adverse event; AS, ankylosing spondylitis; CI, confidence interval; EAIR, exposure adjusted incidence rate per 100 patient-years; MACE, major adverse cardiac events; N, number of patients in the analysis; n, number of patients with event; SAE, serious adverse event


Disclosure: A. A. Deodhar, AbbVie, Amgen, Eli Lilly, GSK, Janssen, Novartis, Pfizer, and UCB, 2,Eli Lilly, Janssen, Novartis, Pfizer, and UCB, 9; X. Baraliakos, AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Werfen, 2,AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Werfen, 5,AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Werfen, 8; H. Marzo-Ortega, Janssen and Pfizer, 2,Abbvie, Celgene, Janssen, Novartis and UCB,, 5,Abbvie, Celgene, Janssen and UCB, 8; J. Sieper, AbbVie, Boehringer Ingelheim, Janssen, Novartis, Merck, Lilly, Pfizer, and UCB, 2,AbbVie, Boehringer Ingelheim, Janssen, Novartis, Merck, Lilly, Pfizer, and UCB, 5; M. Andersson, Novartis Pharma AG, 3; B. Porter, Novartis Pharmaceutical Corporation, 1,Novartis Pharmaceutical Corporation, 3; T. Fox, Novartis Pharma AG, 1,Novartis Pharma AG, 3.

To cite this abstract in AMA style:

Deodhar AA, Baraliakos X, Marzo-Ortega H, Sieper J, Andersson M, Porter B, Fox T. Secukinumab Demonstrates Consistent Safety over Long-Term Exposure (up to 3 years) in Patients with Active Ankylosing Spondylitis: Pooled Analysis of Three Phase 3 Trials [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/secukinumab-demonstrates-consistent-safety-over-long-term-exposure-up-to-3-years-in-patients-with-active-ankylosing-spondylitis-pooled-analysis-of-three-phase-3-trials/. Accessed .
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