Introduction: Ankylosing spondylitis (AS) is a chronic immune-mediated disease characterised by inflammation and new bone formation in the axial skeleton. Current therapeutic strategies include non-steroidal anti-inflammatory drugs, local glucocorticoids and tumour necrosis factor inhibitors. However, an unmet need exists for more treatment options particularly for patients who become unresponsive to and/or cannot tolerate these medications. Interleukin (IL)-17A, a proinflammatory cytokine that plays a crucial role in the pathogenesis of AS, has emerged as a promising target in the search for new therapies. Recently, the IL-17A inhibitor secukinumab has demonstrated significant efficacy in reducing the signs and symptoms of AS.
Areas covered: Inhibition of IL-17A by secukinumab represents a novel therapeutic approach in the management of AS. Secukinumab selectively targets IL-17A and inhibits its interaction with the IL-17 receptor, thus inhibiting the release of proinflammatory cytokines, chemokines and mediators of tissue damage. Here we provide an overview of the pharmacology, clinical efficacy and safety of secukinumab in the treatment of AS.
Expert opinion: Secukinumab has shown strong efficacy and a good safety profile in several immune-mediated diseases including psoriasis, psoriatic arthritis and AS. Secukinumab recently received Food and Drug Administration (FDA) and European Union (EU) approval for the treatment of adult patients with active AS and can be expected to become an established therapy for AS over the next 5 years.
Keywords: Axial spondyloarthritis; IL-17; ankylosing spondylitis; secukinumab; therapy.