Comparative efficacy and safety of secukinumab 75 mg, 150 mg, and 300 mg in patients with active ankylosing spondylitis

The purpose of this research was to assess the efficacy and safety of secukinumab at various doses in patients with active ankylosing spondylitis (AS).A Bayesian network meta-analysis was performed using direct and indirect data from randomized controlled trials (RCTs) investigating the efficacy and safety of secukinumab 75, 150, and 300 mg in patients with active AS.Data of 1,049 patients from three RCTs were examined. In AS patients with inadequate response (IR) to tumor necrosis factor inhibitor (TNFI), secukinumab 300 mg was associated with the most favorable assessment of Spondyloarthritis International Society 40% (ASAS40) response rate according to surface under the cumulative ranking curve (SUCRA), while placebo was associated with the least favorable outcomes. In TNFI-IR patients with AS, ASAS40 was significantly higher in the secukinumab 300, 150, and 75 mg groups than in the placebo group. SUCRA-based rating of likelihood indicated that secukinumab 300 mg was most likely to be the best therapy to achieve ASAS40 response rate, followed by secukinumab 150 mg and 75 mg and placebo. ASAS20 response rate showed a distribution pattern identical to ASAS40 response rate. In TNFI-naïve patients with AS, the response rates for ASAS40 and ASAS20 were also significantly higher in the 300, 150, and 75 mg groups than in the placebo group. There was no substantial difference in the number of severe adverse effects (SAEs) between the treatment groups.Secukinumab demonstrated dose-dependent efficacy in TNFI-IR patients with AS without increasing the risk of SAEs.