Drug Updates: August

Secukinumab is recommended by the National Institute for Health and Care Excellence (NICE) as a treatment option for treating active non-radiographic axial spondyloarthritis with objective signs of inflammation (shown by elevated C-reactive protein or MRI) that cannot be controlled sufficiently by non-steroidal anti-inflammatory drugs (NSAIDs) in adults. It is recommended only if tumour necrosis factor (TNF)-alpha inhibitors are not suitable or do not control the condition well enough.

These recommendations were made because treatment options for non-radiographic axial spondyloarthritis not controlled well enough with NSAIDs is limited to TNF-alpha inhibitors. Clinical trial evidence showed that secukinumab was effective compared with a placebo. There are no trials directly comparing secukinumab with TNF-alpha inhibitors. But an indirect comparison suggests that secukinumab may be less effective than TNF alpha inhibitors. However, this evidence is uncertain.

When treating non-radiographic axial spondyloarthritis, the results of using secukimunab should be accessed after 16 weeks. The treatment should only be continued if there is clear evidence of response, indicated by: