[EULAR HL 2023] Spondyloarthritis II – therapeutic

Author: Stefan Dinescu

Baraliakos et al. (POS1106) studied the achievement of low disease activity in patients with axSpA treated with bimekizumab over 52 weeks. A greater proportion of patients with both nr-axSpA and r-axSpA obtained LDA at week 16 compared to the placebo group. LDA, according ASDAS <2.1, BASDAI <4, and both, was maintained or improved up to week 52. The proportion of patients which achieved BASDAI <4 was consistently higher compared with achievement of ASDAS <2.1.

Rudwaleit et al. (POS0683) investigated the disconnect between the objective inflammatory response and clinical response following treatment with certolizumab pegol in axSpA. Improvement of objective endpoints which included CRP, ASspiMRI Berlin score, and SPARCC MRI SIJ, was obtained in most patients, while a reduction of clinical response was observed in only a minority of patients with both r-axSpA and nr-axSpA patients. 

Baraliakos et al. (POS0246) evaluated the efficacy of bimekizumab in reducing MRI inflammatory lesions in patients with axSpA. At week 16, patients treated with bimekizumab obtained greater reduction in mean absolute MRI inflammation score and had a greater proportion MRI remission for both SIJ and spine MRI endpoints, compared to placebo. Both bimekizumab and PBO-switcher treatment arms largely improved the proportion of MRI remission at week 52. 

Baraliakos et al. (POS1115) studied the effect of secukinumab versus adalimumab biosimilar on radiographic progression in patients with r-axSpA. Baseline features associated with the least progression in all radiographic outcomes included lack of syndesmophytes followed by absence of elevated high-sensitivity CRP levels. No notable difference was observed between secukinumab and adalimumab regarding spinal radiographic progression over 2 years. 

Navarro-Compán et al. (POS1108) studied the efficacy of upadacitinib in patients with nr-axSpA with objective signs of inflammation (MRI of SI joint or CRP) with regard to the difference between early versus established disease. ASAS40 and ASDAS LDA response rates were significantly increased at week 14 after UPA compared to placebo. Treatment responses were numerically higher in the subgroup with early disease versus established disease, although the differences were not statistically significant. 

Van den Bosch et al. (POS0250) evaluated the efficacy and safety of upadacitinib in patients with nr-axSpA in a 52 week double-blind placebo-controlled trial. Achievement of ASAS40 response and proportion of patients with ASDAS inactive disease was significantly higher in patients with upadacitinib compared to placebo, starting from week 14. There were no new safety risk identified after long-term upadacitinibexposure. 


Stefan Dinescu


Stefan Dinescu is a rheumatology specialist at the Emergency County Hospital in Craiova (Romania) and lecturer at the University of Medicine and Pharmacy Craiova (Romania).

Research interests include axial spondyloarthritis and musculoskeletal ultrasonography.

Stefan is a member of the Education Subcommittee

Leave a Reply