Comparative effectiveness of secukinumab and adalimumab in ankylosing spondylitis as assessed by matching-adjusted indirect comparison

Abstract

Objective: Matching-adjusted indirect comparison was used to assess the comparative effec-tiveness of secukinumab 150 mg and adalimumab 40 mg in biologic-naïve patients with anky-losing spondylitis (AS) for up to 1 year.Methods: Pooled individual patient data from the secukinumab arms of MEASURE 1(NCT01358175) and MEASURE 2 (NCT01649375) trials (n=197) were matched against the AT-LAS (NCT00085644) adalimumab population (n=208). Logistic regression analysis was usedto determined weights to match for age, sex, Bath AS Functional Index, C-reactive proteinlevels, and previous tumor necrosis factor inhibitor therapy. Recalculated Assessment of Spon-dyloArthritis International Society (ASAS) 20 and 40 responses at weeks 8, 12, 16, 24, and 52from MEASURE 1/2 (effective sample size=120) were compared with those of ATLAS. Anchored(placebo-adjusted) comparisons were possible until week 12, and unanchored (non-place-bo-adjusted) comparisons were necessary thereafter.Results: For placebo-anchored ASAS 20 and 40 comparisons up to week 12, there were nodifferences between secukinumab and adalimumab. For unanchored comparisons at week16, ASAS 20 was higher for secukinumab [odds ratio 1.60 (95% confidence interval, 1.01-2.54);p=0.047]; at week 24, ASAS 20 and 40 were higher for secukinumab [1.76 (1.11-2.79); p=0.017and 1.79 (1.14-2.82); p=0.012, respectively]; and at week 52, ASAS 40 was higher for secukinum-ab [1.54 (1.06-2.23); p=0.023] than for adalimumab.Conclusion: There were no differences observed in placebo-adjusted ASAS 20 and 40 respons-es up to 12 weeks between secukinumab- and adalimumab-treated patients with ankylos-ing spondylitis. After week 12, secukinumab demonstrated signs of greater improvement innon-placebo-adjusted ASAS 20 and 40 responses than adalimumab.