As physicians are discovering limitations of TNF-α inhibitors in treating ankylosing spondylitis, a local doctor has stressed that there is a need to remove the obstacles blocking interleukin entry (IL)-17A inhibitors.

Professor Hong Seung-jae of Kyunghee University Hospital explains the benefits of using Cosentyx in treating ankylosing spondylitis patients, during a news conference at the Plaza Hotel Seoul on Tuesday.
Professor Hong Seung-jae of Kyunghee University Hospital explains the benefits of using Cosentyx in treating ankylosing spondylitis patients, during a news conference at the Plaza Hotel Seoul on Tuesday.

"Patients with ankylosing spondylitis suffer from pain and irreversible spinal deformity throughout their lives," said Professor Hong Seung-jae of Kyunghee University Hospital, during a media organized by Novartis on Tuesday.

An important principle in treating ankylosing spondylitis is treat-to-target (T2T), which aims to eliminate pain in the patient and maintain the patient's quality of life while protecting the body structure, Hong added.

Ankylosing spondylitis is a disease that begins with sacroiliac arthritis, structural damage due to inflammation, which, in turn, can lead to irreversible spinal stiffness. The condition is most common in men under 45, especially those aged between 20 and 29. There are about 50,000 patients in Korea, and the number of patients has steadily increased in recent years.

In the past, hospitals relied strongly on steroids as there were no treatment options. With the discovery of TNF-α inhibitors in 2000, patients with ankylosing spondylitis could finally escape from the pain of inflammation. However, as antibody drugs are less effective in treatment due to antibody resistance, a need for a new treatment has risen.

As TNF-α inhibitors cannot prevent structural damage caused by ankylosing spondylitis, a fundamental treatment option that can act on the disease's mechanism has been raised among local doctors.

Professor Hong stressed in this regard that Cosentyx, an IL-17A inhibitor, is the best treatment to reach ankylosing spondylitis treatment goals of clinical remission and prevention of structural damage.

"Cosentyx has a mechanism to prevent bone damage by directly blocking IL-17A, which is a protein primarily involved in the inflammatory response of ankylosing spondylitis," Hong said. "The interleukin interferes with bone formation and maintenance of homeostasis, affecting the inflammatory response and bone reconstruction of patients with ankylosing spondylitis."

As IL-17 has shown to play an important role, it is important to block this mechanism by using Cosentyx, Hong emphasized, explaining the difference in treating patients with 150mg or 300mg of Cosentyx.

"According to the MEASURE 3 study, treatment with Cosentyx 300mg could achieve both the main treatment goals of remission and the replacement goal of low disease activity maintenance," Hong said.

In detail, the study showed that the treatment maintenance rates for Cosentyx 300mg and 150mg from 16 weeks to 156 weeks were 80.5 and 80.9 percent, respectively.

Also, Assessment of Spondyloarthritis International Society criteria 20/40 response rate at week 156 was 75 percent and 56.5 percent in the Cosentyx 300mg group, and 68.2 percent and 47.7 percent in the Cosentyx 150mg group.

In terms of safety, Novartis confirmed that Cosentyx 300mg maintained a partial response to ASAS for three years.

"Patients who have failed TNF inhibitor treatment can achieve their treatment goals by administering Cosentyx 300mg and prevent clinical and structural damage," Hong said.

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