SURPASS (secukinumab 150 mg)
Trial question
What is the difference between secukinumab and adalimumab in patients with radiographic axial spondyloarthritis?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
21.0% female
79.0% male
N = 573
573 patients (122 female, 451 male).
Inclusion criteria: biologic-naïve patients with active radiographic axial spondyloarthritis at high risk of radiographic progression.
Key exclusion criteria: total spinal ankylosis; active systemic infection in the past 2 weeks.
Interventions
N=287 secukinumab (at a dose of 150 mg).
N=286 adalimumab (at a dose of 40 mg).
Primary outcome
No radiographic progression at week 104
66.1%
65.6%
66.1 %
49.6 %
33.0 %
16.5 %
0.0 %
Secukinumab
Adalimumab
No significant
difference ↔
No significant difference in no radiographic progression at week 104 (66.1% vs. 65.6%; MD 1.51, 95% CI -6.63 to 9.64).
Secondary outcomes
No significant difference in mean reduction in modified Stoke Ankylosing Spondylitis Spinal Score (0.54 points vs. 0.72 points; MD -0.18, 95% CI -0.65 to 0.29).
No significant difference in no new syndesmophytes at week 104 (56.9% vs. 53.3%; MD 4.32, 95% CI -5.62 to 14.27).
Safety outcomes
No significant difference in adverse and serious adverse events.
Conclusion
In biologic-naïve patients with active radiographic axial spondyloarthritis at high risk of radiographic progression, secukinumab was equivalent to adalimumab with respect to no radiographic progression at week 104.
Reference
Xenofon Baraliakos, Mikkel Østergaard, Denis Poddubnyy et al. Effect of Secukinumab Versus Adalimumab Biosimilar on Radiographic Progression in Patients With Radiographic Axial Spondyloarthritis: Results From a Head-to-Head Randomized Phase IIIb Study. Arthritis Rheumatol. 2024 Aug;76(8):1278-1287.
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