Patients with non-radiographic axial spondyloarthritis (nr-axSpA) benefit from long-term treatment with adalimumab (Humira), according to new research.
Axial spondyloarthritis (axSpA) is a chronic form of arthritis that causes significant inflammatory low back and/or buttock pain that persists more than three months. Non-radiographic axial spondyloarthritis (nr-axSpA) is the earlier form of the disease in which lesions in the sacroiliac joint -- the link between the lower spine and pelvis -- are only detected through magnetic resonance imaging (MRI) and clinical criteria, and cannot be seen on a standard X-ray.
Adalimumab is an antibody that targets the pro-inflammatory molecule tumour necrosis factor-alpha. It is already used to treat conditions including plaque psoriasis, rheumatoid arthritis and Crohn's disease, as well as ankylosing spondylitis (AS), a chronic inflammatory disease that affects parts of the spine including the bones, muscles and ligaments.
Results of the ABILITY-1 study of nr-axSpA published in Arthritis Research & Therapy show that treatment with adalimumab over three years led to sustained improvements in physical function, and MRI scans taken at year one and two showed a significant and sustained suppression of inflammation in both the spine and sacroiliac joint.
A separate study published in Rheumatology examined the effectiveness of tofacitinib for treating AS patients, and showed that it may improve outcomes.
Nearly one-third of patients with ankylosing spondylitis who received tofacitinib in the 12-week study had a substantial reduction in spinal inflammation as measured by minimally important changes on MRI.
However, although more participants taking tofacitinib achieved minimally important changes in spinal inflammation and participants who reached minimally important changes also achieved larger clinical improvements in other measures, most comparisons did not reach statistical significance. As a result, longer-term studies involving more participants are needed to confirm the findings of this study.