Management of nr-AxSpA: Emerging Agents and IFAA

Transcript:Sergio Schwartzman, MD: Philip, can you briefly summarize for us agents that are in the pipeline? What do we expect to see in this disease state, and what new therapies should we expect in the near future?

Philip J. Mease, MD: Fortunately, there are several therapies in the pipeline. We already know that the interleukin-17 inhibitors can be highly effective in treating ankylosing spondylitis, or radiographic axial spondyloarthritis, and there are studies in nonradiographic axial spondyloarthritis as well that are showing positive results. The 2 that are currently approved are secukinumab and ixekizumab. There is another IL-17A IL-17F inhibitor that’s en route known as bimekizumab that showed promising results. So we should see that these drugs as well as the TNF [tumor necrosis factor] inhibitors beneficially used once approval occurs for them in the nonradiographic axial spondyloarthritis indication.

We’re also seeing positive results coming forward with the JAK inhibitor class, or Janus kinase inhibitors. These are once-a-day oral medications, which influence a number of different cytokines. We’re seeing ankylosing spondylitis trials, for example, with tofacitinib. We’re seeing good results in radiographic axial spondyloarthritis. To be seen further down the road is likely nonradiographic axial spondyloarthritis with upadacitinib and filgotinib.

The other medications that we’ve seen in diseases like rheumatoid arthritis or even psoriatic arthritis, which have not shown beneficial effects include the IL-12/IL-23 inhibitor, which is ustekinumab, or 1 of the IL-23 inhibitors, risankizumab. We can’t expect all the drugs that have been successful in psoriatic arthritis, 1 of the family members, so to speak of the spondyloarthritis class, to be necessarily effective in axial spondyloarthritis. Fortunately, we’ve got some very solid evidence coming for several other mechanisms of action.

Sergio Schwartzman, MD: Thank you. My last question before we summarize the program is going to be directed toward Tiffany and asking her to educate us a little about what the IFAA [International Foundation for Autoimmune & Autoinflammatory Arthritis] actually is. I’m going to ask you to inform us. At least for Philip and me, this was something that was new. I don’t know if Atul had heard of this before.

Tiffany Westrich-Robertson: The IFAA is the International Foundation for Autoimmune & Autoinflammatory Arthritis. We’re an international nonprofit that is led by people who live with autoimmune or autoinflammatory arthritis diseases. We help facilitate conversations and get the voice of the patient involved in discussions that can impact changes in education advocacy and research. That is our mission, and as far as efforts with nonradiographic axial spondyloarthritis and other autoimmune or autoinflammatory arthritis diseases, we really are working on, as Philip said, “education, education, education.”

As people living with these diseases, we can certainly help others understand what we are experiencing and what is needed to expedite with detection, referrals, and diagnosis and then inevitably have a better quality of life and outcomes. That’s the hallmark of what we do. Everything falls under that early detection, and the result is quality of life by engaging with patients and making sure their voices count.

Sergio Schwartzman, MD: Thank you.

Transcript Edited for Clarity