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Study to Examine the Clinical Efficacy and the Nonsteroidal Anti-inflammatory Drug (NSAID)-Sparing Effect of Secukinumab Over 16 Weeks in Patients With Ankylosing Spondylitis

A Randomized, Double-blind, Placebo-controlled Multicenter Study of Secukinumab (AIN457) to Examine the Clinical Efficacy and the NSAID-sparing Effect of Secukinumab Over 16 Weeks in Patients With Ankylosing Spondylitis (ASTRUM)

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02763046
Acronym
ASTRUM
Enrollment
211
Registered
2016-05-05
Start date
2016-05-31
Completion date
2019-09-24
Last updated
2021-10-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Ankylosing Spondylitis

Keywords

Ankylosing Spondylitis, NSAID, ASAS, ASAS-NSAID score, Secukinumab

Brief summary

This study assessed the clinical Assessment of SpondyloArthritis international Society (ASAS) 20 response to secukinumab and evaluated to which extent concomitant nonsteroidal anti-inflammatory drug (NSAID) treatment can be reduced in patients treated with secukinumab or placebo following an initial run-in phase of stable NSAID therapy.

Detailed description

This was a phase IV, 20-week, randomized, double-blind, 3-arm, placebo-controlled, parallel-group, multicenter study to examine the clinical response of secukinumab treatment in patients with ankylosing spondylitis as measured by the Assessment of SpondyloArthritis international Society (ASAS) 20 response and the nonsteroidal anti-inflammatory drug (NSAID)-sparing effect. This study evaluated to which extent nonsteroidal anti-inflammatory drug (NSAID) treatment can be reduced between Week 4 and Week 12 in patients randomized to secukinumab 150 mg or placebo following an initial run-in phase of 4 weeks on stable NSAID therapy. Two NSAID tapering approaches were evaluated in this study: 1. an early tapering approach in which NSAID were tapered at the start of secukinumab treatment, 2. a delayed tapering approach in which NSAID were tapered following 4 weeks of secukinumab treatment. Patients were randomized 1:1:1 to one of the following treatment groups: * Secukinumab - delayed NSAID tapering: Induction with secukinumab 150 mg s.c. once per week (Week 0, 1, 2, 3 and 4) followed by maintenance with secukinumab 150 mg s.c. every 4 weeks (Week 8, 12, 16 and 20), with intermittent placebo injections at Week 5, 6, 7, 17, 18 and 19 to maintain the blind. NSAID tapering allowed from Week 4 (delayed tapering). * Secukinumab - early NSAID tapering: Placebo at weeks 0, 1, 2, 3 to maintain the blind; followed by induction with secukinumab 150 mg s.c. once per week (Week 4, 5, 6, 7, 8) and maintenance with secukinumab 150 mg s.c. every 4 weeks (Week 12, 16 and 20), with intermittent placebo injections at Week 17, 18 and 19 to maintain the blind. NSAID tapering allowed from Week 4 (early tapering). * Placebo: Placebo s.c. at Week 0, 1, 2, 3, 4, 5, 6, 7, 8 and 12. After the Week 16 assessments of the secondary endpoint had been performed, these patients received weekly doses of secukinumab 150 mg s.c. (Week 16, 17, 18, 19 and 20). NSAID tapering allowed from Week 4. The primary objective of the study was to demonstrate that the efficacy of secukinumab 150 mg subcutaneous (s.c.) injection (with NSAID tapering) is superior to placebo based on the proportion of patients achieving an ASAS20 response at Week 12. To show superiority, both secukinumab treatment arms were pooled and compared against placebo.

Interventions

DRUGSecukinumab (AIN457) 150 mg s.c.

Induction: 5 x 150 mg secukinumab s.c. weekly Maintenance: 4 x 150 mg secukinumab s.c. every 4 weeks Delayed NSAID tapering (tapering following 4 weeks of secukinumab treatment).

DRUGPlacebo - Secukinumab (AIN457) 150 mg s.c.

Placebo for 15 weeks. From Week 16 on, 5 x 150 mg secukinumab s.c. weekly.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * Diagnosis of active AS with prior documented radiologic evidence fulfilling the Modified New York criteria for AS * Active AS assessed by total BASDAI ≥ 4 (0-10) at baseline * Spinal pain as measured by BASDAI Question 2 ≥ 4 cm on a 0-10 cm numeric rating scale at baseline * Total back pain as measured by VAS ≥ 40 mm (0-100 mm) at baseline * Patients should have been on at least 2 different NSAIDs at the highest recommended dose for at least 4 weeks prior to randomization, with an inadequate response or failure to respond, or less if therapy had to be reduced due to intolerance, toxicity or contraindications * Patients must report regular intake of NSAIDs of at least 50% of the highest recommended dose at Screening. * Patients with prior TNFα inhibitor therapy must report regular intake of NSAIDs of at least 50% of the highest recommended dose at baseline after the appropriate washout * Patients are required to be on a stable dose of NSAIDs for at least 2 weeks before randomization * Patients who have previously been on a TNFα inhibitor will be allowed entry into study after an appropriate wash-out period prior to randomization * Patients who have been on a TNFα inhibitor (not more than two) must have experienced an inadequate response to previous or current treatment given at an approved dose for at least 3 months prior to randomization or have been intolerant to at least one administration of an anti-TNFα agent. * Patients taking MTX or sulfasalazine are allowed to continue their medication and must have taken it for at least 3 months and be on a stable dose for at least 4 weeks prior to randomization Key

Exclusion criteria

* Chest X-ray or MRI with evidence of ongoing infectious or malignant process. * Previous exposure to Secukinumab or any other biologic drug directly targeting IL-17 or IL-17 receptor * Patients previously treated with any biological immunomodulating agents, except those targeting TNFα * Patients who have taken more than two anti-TNFα agents * Pregnant or nursing (lactating) women. * History of ongoing, chronic or recurrent infectious disease or evidence of tuberculosis infection. * Patients who are intolerant to NSAIDs

Design outcomes

Primary

MeasureTime frameDescription
Proportion of Patients Who Achieved ASAS20 Response in the Pooled Secukinumab Group Compared With the Placebo Group at Week 12Baseline, Week 12ASAS (Assessment of SpondyloArthritis International Society criteria) 20 response is defined as an improvement from baseline of ≥20% and ≥1 unit on a scale of 0-10 in at least three of the four ASAS main domains and no worsening of ≥20% and ≥1 unit on a scale of 0-10 in the remaining domain. The four main ASAS domains are: Patient's global assessment of disease activity, back pain, function represented by ability to perform specific tasks (from Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]) and inflammation represented by mean duration and severity of morning stiffness. Non-responder imputation was applied for missing data.

Secondary

MeasureTime frameDescription
Proportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupBaseline, Week 12, Week 16ASAS (Assessment of SpondyloArthritis International Society criteria) 20 response is defined as an improvement from baseline of ≥20% and ≥1 unit on a scale of 0-10 in at least three of the four ASAS main domains and no worsening of ≥20% and ≥1 unit on a scale of 0-10 in the remaining domain. The four main ASAS domains are: Patient's global assessment of disease activity, back pain, function represented by ability to perform specific tasks (from Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]) and inflammation represented by mean duration and severity of morning stiffness. Non-responder imputation was applied for missing data.
Mean Change From Baseline in ASAS-NSAID Score at Week 12Baseline, Week 12ASAS-NSAID score is used to present the NSAID (nonsteroidal anti-inflammatory drug) intake by considering the type of NSAID, the total dose and the number of days taking NSAID during a period of interest (PI). For the NSAID equivalence scoring system, no NSAID intake was set to a score value of 0, and the reference dose of 150 mg/day diclofenac was set to a score value of 100. The Daily diclofenac-equivalent dose score was derived by converting each daily dose of NSAID to a percentage dose equivalent of 150 mg diclofenac. ASAS-NSAID score = (equivalent NSAID score) x (days of intake during PI) x (days per week)/(PI in days). A negative change from baseline indicates less NSAID consumption.
Mean Change From Baseline in ASAS-NSAID Score in Each Secukinumab Group After 12 Weeks of Exposure (at Week 12 in the Secukinumab-delayed NSAID Tapering Group and at Week 16 in the Secukinumab-early NSAID Tapering Group)Baseline, Week 12 (delayed NSAID tapering), Week 16 (early NSAID tapering)ASAS-NSAID score is used to present the NSAID (nonsteroidal anti-inflammatory drug) intake by considering the type of NSAID, the total dose and the number of days taking NSAID during a period of interest (PI). For the NSAID equivalence scoring system, no NSAID intake was set to a score value of 0, and the reference dose of 150 mg/day diclofenac was set to a score value of 100. The Daily diclofenac-equivalent dose score was derived by converting each daily dose of NSAID to a percentage dose equivalent of 150 mg diclofenac. ASAS-NSAID score = (equivalent NSAID score) x (days of intake during PI) x (days per week)/(PI in days). A negative change from baseline indicates less NSAID consumption. For this endpoint the analysis was performed after 12 weeks of exposure to secukinumab which was achieved at Week 12 in the secukinumab delayed NSAID tapering group but at Week 16 in the secukinumab early NSAID tapering group.
Mean Change From Baseline in the BASDAI Total ScoreBaseline, Week 12, Week 16The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a participant-reported assessment consisting of 6 questions that relate to 5 major symptoms relevant to ankylosing spondylitis: 1) Fatigue, 2) Spinal pain, 3) Peripheral arthritis, 4) Enthesitis, 5) Intensity, and 6) Duration of morning stiffness. Participants need to score each item with a score from 0 to 10 (captured as a continuous visual analog scale). Total score is obtained from the average of symptom scores ranging 0 (no problem) to 10 (worst problem), with a higher score indicating more severe symptoms. A negative change from baseline in the total 0-10 BASDAI score indicates improvement.
Mean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) ScoreBaseline, Week 12The Short Form-36 Health Survey (SF-36) measures the impact of disease on overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36 (SF-36 PCS) that is evaluated in this study. Scores on each item 1-4 were summed and averaged (range = 0-100 with higher scores indicating better levels of function and/or better health). A positive change from Baseline indicates improvement.

Countries

Germany

Participant flow

Recruitment details

Participants took part in 40 investigative sites in Germany.

Pre-assignment details

Participants were randomized 1:1:1 to one of the following treatment groups: secukinumab 150 mg s.c. with delayed NSAID tapering, secukinumab 150 mg s.c. with early NSAID tapering and placebo.

Participants by arm

ArmCount
Secukinumab - Delayed NSAID Tapering
Induction with secukinumab 150 mg s.c. once per week (Week 0, 1, 2, 3 and 4) followed by maintenance with secukinumab 150 mg s.c. every 4 weeks (Week 8, 12, 16 and 20), with intermittent placebo injections at Week 5, 6, 7, 17, 18 and 19 to maintain the blind. NSAID tapering allowed from Week 4 (delayed tapering).
71
Secukinumab - Early NSAID Tapering
Placebo at weeks 0, 1, 2, 3 to maintain the blind; followed by induction with secukinumab 150 mg s.c. once per week (Week 4, 5, 6, 7, 8) and maintenance with secukinumab 150 mg s.c. every 4 weeks (Week 12, 16 and 20), with intermittent placebo injections at Week 17, 18 and 19 to maintain the blind. NSAID tapering allowed from Week 4 (early tapering).
70
Placebo
Placebo s.c. at Week 0, 1, 2, 3, 4, 5, 6, 7, 8 and 12. After the Week 16 assessments of the secondary endpoint had been performed, these patients received weekly doses of secukinumab 150 mg s.c. (Week 16, 17, 18, 19 and 20). NSAID tapering allowed from Week 4.
70
Total211

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event540
Overall StudyLack of Efficacy113
Overall StudyPhysician Decision101
Overall StudySubject/guardian decision204

Baseline characteristics

CharacteristicSecukinumab - Early NSAID TaperingPlaceboSecukinumab - Delayed NSAID TaperingTotal
Age, Continuous44.1 Years
STANDARD_DEVIATION 11.02
45.4 Years
STANDARD_DEVIATION 12.55
46.2 Years
STANDARD_DEVIATION 13.36
45.2 Years
STANDARD_DEVIATION 12.32
Race/Ethnicity, Customized
Asian
2 Participants1 Participants0 Participants3 Participants
Race/Ethnicity, Customized
Black
0 Participants0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Caucasian
67 Participants68 Participants69 Participants204 Participants
Race/Ethnicity, Customized
Other
1 Participants1 Participants1 Participants3 Participants
Sex: Female, Male
Female
28 Participants31 Participants30 Participants89 Participants
Sex: Female, Male
Male
42 Participants39 Participants41 Participants122 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
0 / 710 / 700 / 700 / 710 / 700 / 70
other
Total, other adverse events
53 / 7156 / 7055 / 7025 / 7123 / 7022 / 70
serious
Total, serious adverse events
4 / 713 / 701 / 701 / 710 / 701 / 70

Outcome results

Primary

Proportion of Patients Who Achieved ASAS20 Response in the Pooled Secukinumab Group Compared With the Placebo Group at Week 12

ASAS (Assessment of SpondyloArthritis International Society criteria) 20 response is defined as an improvement from baseline of ≥20% and ≥1 unit on a scale of 0-10 in at least three of the four ASAS main domains and no worsening of ≥20% and ≥1 unit on a scale of 0-10 in the remaining domain. The four main ASAS domains are: Patient's global assessment of disease activity, back pain, function represented by ability to perform specific tasks (from Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]) and inflammation represented by mean duration and severity of morning stiffness. Non-responder imputation was applied for missing data.

Time frame: Baseline, Week 12

Population: Full analysis set (FAS) comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Secukinumab - PooledProportion of Patients Who Achieved ASAS20 Response in the Pooled Secukinumab Group Compared With the Placebo Group at Week 1272 Participants
PlaceboProportion of Patients Who Achieved ASAS20 Response in the Pooled Secukinumab Group Compared With the Placebo Group at Week 1231 Participants
p-value: 0.351295% CI: [0.74, 2.36]Regression, Logistic
Secondary

Mean Change From Baseline in ASAS-NSAID Score at Week 12

ASAS-NSAID score is used to present the NSAID (nonsteroidal anti-inflammatory drug) intake by considering the type of NSAID, the total dose and the number of days taking NSAID during a period of interest (PI). For the NSAID equivalence scoring system, no NSAID intake was set to a score value of 0, and the reference dose of 150 mg/day diclofenac was set to a score value of 100. The Daily diclofenac-equivalent dose score was derived by converting each daily dose of NSAID to a percentage dose equivalent of 150 mg diclofenac. ASAS-NSAID score = (equivalent NSAID score) x (days of intake during PI) x (days per week)/(PI in days). A negative change from baseline indicates less NSAID consumption.

Time frame: Baseline, Week 12

Population: FAS comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureValue (MEAN)Dispersion
Secukinumab - PooledMean Change From Baseline in ASAS-NSAID Score at Week 12-44.9 Score on scaleStandard Deviation 47.32
PlaceboMean Change From Baseline in ASAS-NSAID Score at Week 12-40.3 Score on scaleStandard Deviation 71.48
PlaceboMean Change From Baseline in ASAS-NSAID Score at Week 12-31.5 Score on scaleStandard Deviation 36.54
Secukinumab - PooledMean Change From Baseline in ASAS-NSAID Score at Week 12-42.6 Score on scaleStandard Deviation 60.53
p-value: 0.099795% CI: [-22.55, 1.96]Mixed Model for Repeated Measures (MMRM)
p-value: 0.088895% CI: [-26.47, 1.87]Mixed Model for Repeated Measures (MMRM)
p-value: 0.248495% CI: [-22.36, 5.79]Mixed Model for Repeated Measures (MMRM)
Secondary

Mean Change From Baseline in ASAS-NSAID Score in Each Secukinumab Group After 12 Weeks of Exposure (at Week 12 in the Secukinumab-delayed NSAID Tapering Group and at Week 16 in the Secukinumab-early NSAID Tapering Group)

ASAS-NSAID score is used to present the NSAID (nonsteroidal anti-inflammatory drug) intake by considering the type of NSAID, the total dose and the number of days taking NSAID during a period of interest (PI). For the NSAID equivalence scoring system, no NSAID intake was set to a score value of 0, and the reference dose of 150 mg/day diclofenac was set to a score value of 100. The Daily diclofenac-equivalent dose score was derived by converting each daily dose of NSAID to a percentage dose equivalent of 150 mg diclofenac. ASAS-NSAID score = (equivalent NSAID score) x (days of intake during PI) x (days per week)/(PI in days). A negative change from baseline indicates less NSAID consumption. For this endpoint the analysis was performed after 12 weeks of exposure to secukinumab which was achieved at Week 12 in the secukinumab delayed NSAID tapering group but at Week 16 in the secukinumab early NSAID tapering group.

Time frame: Baseline, Week 12 (delayed NSAID tapering), Week 16 (early NSAID tapering)

Population: FAS comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureValue (MEAN)Dispersion
Secukinumab - PooledMean Change From Baseline in ASAS-NSAID Score in Each Secukinumab Group After 12 Weeks of Exposure (at Week 12 in the Secukinumab-delayed NSAID Tapering Group and at Week 16 in the Secukinumab-early NSAID Tapering Group)-44.9 Score on scaleStandard Deviation 47.32
PlaceboMean Change From Baseline in ASAS-NSAID Score in Each Secukinumab Group After 12 Weeks of Exposure (at Week 12 in the Secukinumab-delayed NSAID Tapering Group and at Week 16 in the Secukinumab-early NSAID Tapering Group)-42.5 Score on scaleStandard Deviation 68.62
Comparison: delayed tapering (W12) vs early tapering (W16)p-value: 0.773595% CI: [-16.11, 11.98]Mixed Model for Repeated Measures (MMRM)
Secondary

Mean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score

The Short Form-36 Health Survey (SF-36) measures the impact of disease on overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36 (SF-36 PCS) that is evaluated in this study. Scores on each item 1-4 were summed and averaged (range = 0-100 with higher scores indicating better levels of function and/or better health). A positive change from Baseline indicates improvement.

Time frame: Baseline, Week 12

Population: FAS comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureValue (MEAN)Dispersion
Secukinumab - PooledMean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score4.8 Score on scaleStandard Deviation 7.03
PlaceboMean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score6.1 Score on scaleStandard Deviation 6.92
PlaceboMean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score4.8 Score on scaleStandard Deviation 7.43
Secukinumab - PooledMean Change From Baseline in Health-related Quality of Life as Measured by the Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score5.5 Score on scaleStandard Deviation 6.98
p-value: 0.538495% CI: [-1.38, 2.63]Mixed Model for Repeated Measures (MMRM)
p-value: 0.925195% CI: [-2.43, 2.21]Mixed Model for Repeated Measures (MMRM)
p-value: 0.243295% CI: [-0.93, 3.66]Mixed Model for Repeated Measures (MMRM)
Secondary

Mean Change From Baseline in the BASDAI Total Score

The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a participant-reported assessment consisting of 6 questions that relate to 5 major symptoms relevant to ankylosing spondylitis: 1) Fatigue, 2) Spinal pain, 3) Peripheral arthritis, 4) Enthesitis, 5) Intensity, and 6) Duration of morning stiffness. Participants need to score each item with a score from 0 to 10 (captured as a continuous visual analog scale). Total score is obtained from the average of symptom scores ranging 0 (no problem) to 10 (worst problem), with a higher score indicating more severe symptoms. A negative change from baseline in the total 0-10 BASDAI score indicates improvement.

Time frame: Baseline, Week 12, Week 16

Population: FAS comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureGroupValue (MEAN)Dispersion
Secukinumab - PooledMean Change From Baseline in the BASDAI Total ScoreWeek 12-2.1 Score on scaleStandard Deviation 2.16
Secukinumab - PooledMean Change From Baseline in the BASDAI Total ScoreWeek 16-2.3 Score on scaleStandard Deviation 1.9
PlaceboMean Change From Baseline in the BASDAI Total ScoreWeek 16-2.0 Score on scaleStandard Deviation 1.96
PlaceboMean Change From Baseline in the BASDAI Total ScoreWeek 12-2.0 Score on scaleStandard Deviation 2.1
PlaceboMean Change From Baseline in the BASDAI Total ScoreWeek 12-1.8 Score on scaleStandard Deviation 2
PlaceboMean Change From Baseline in the BASDAI Total ScoreWeek 16-1.7 Score on scaleStandard Deviation 1.96
Secukinumab - PooledMean Change From Baseline in the BASDAI Total ScoreWeek 12-2.1 Score on scaleStandard Deviation 2.12
Secukinumab - PooledMean Change From Baseline in the BASDAI Total ScoreWeek 16-2.2 Score on scaleStandard Deviation 1.93
Comparison: Week 12p-value: 0.192695% CI: [-0.99, 0.2]Mixed Model for Repeated Measures (MMRM)
Comparison: Week 12p-value: 0.191495% CI: [-1.14, 0.23]Mixed Model for Repeated Measures (MMRM)
Comparison: Week 12p-value: 0.339795% CI: [-1.01, 0.35]Mixed Model for Repeated Measures (MMRM)
Comparison: Week 16p-value: 0.038495% CI: [-1.33, -0.04]Mixed Model for Repeated Measures (MMRM)
Comparison: Week 16p-value: 0.211695% CI: [-1.05, 0.23]Mixed Model for Repeated Measures (MMRM)
Secondary

Proportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo Group

ASAS (Assessment of SpondyloArthritis International Society criteria) 20 response is defined as an improvement from baseline of ≥20% and ≥1 unit on a scale of 0-10 in at least three of the four ASAS main domains and no worsening of ≥20% and ≥1 unit on a scale of 0-10 in the remaining domain. The four main ASAS domains are: Patient's global assessment of disease activity, back pain, function represented by ability to perform specific tasks (from Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]) and inflammation represented by mean duration and severity of morning stiffness. Non-responder imputation was applied for missing data.

Time frame: Baseline, Week 12, Week 16

Population: FAS comprising all subjects from the randomized set to whom study treatment was assigned.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Secukinumab - PooledProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1237 Participants
Secukinumab - PooledProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1640 Participants
PlaceboProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1235 Participants
PlaceboProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1635 Participants
PlaceboProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1231 Participants
PlaceboProportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo GroupWeek 1629 Participants
Comparison: Week 12p-value: 0.40195% CI: [0.68, 2.6]Regression, Logistic
Comparison: Week 12p-value: 0.438295% CI: [0.67, 2.55]Regression, Logistic
Comparison: Week 16p-value: 0.093495% CI: [0.91, 3.5]Regression, Logistic
Comparison: Week 16p-value: 0.261995% CI: [0.75, 2.9]Regression, Logistic

Source: ClinicalTrials.gov · Data processed: Feb 7, 2026