Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Medical Student
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Medical Student
Discipline/Specialty (Author 3)
Internal Medicine
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background:
Ankylosing Spondylitis (AS) is a chronic inflammatory disease affecting the axial skeleton, characterized by spinal stiffness, sacroiliitis, and potential vertebral fusion. While nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitors are first-line treatments, IL-17 inhibitors, such as secukinumab and ixekizumab, are used in patients with inadequate response or contraindications to TNF inhibitors. These targeted therapies address IL-17’s role in driving inflammation and structural damage in AS.
Methods:
A systematic review was conducted using PubMed, Science Direct, and Cochrane to identify studies published between 2000 and 2025. Keywords included “Ankylosing spondylitis” and “IL-17 inhibitors” and “efficacy.” Inclusion criteria focused on randomized controlled trials, observational studies, and meta-analyses reporting long-term outcomes, safety, and efficacy of IL-17 inhibitors in AS. Articles lacking primary data or focusing on other diseases were excluded. Initial search yielded 205 articles with 50 meeting the criteria.
Results:
IL-17 inhibitors, including secukinumab, ixekizumab, and netakimab, have shown significant effectiveness and safety in the long-term treatment of ankylosing spondylitis (AS). Secukinumab and ixekizumab improved the Assessment of SpondyloArthritis International Society 40% response (ASAS40) at Week 16, with response rates between 52% and 60.5%, and maintained these benefits over 1 to 5 years. Long-term response rates for ASAS40 and the Bath Ankylosing Spondylitis Disease Activity Index 50% response (BASDAI 50) were both above 60%. One clinical trial showed patients experienced improvements in spinal pain, physical function, and quality of life, with most showing sustained reductions in disease activity and little to no radiographic progression. In fact, over 93% of patients had no structural damage progression after 2 years. The safety profiles of IL-17 inhibitors were consistent, with the most common issues being mild infections and injection site reactions. Serious side effects, like severe infections or Crohn’s disease, were rare and manageable. Economic evaluations suggested netakimab as the most cost-effective IL-17 inhibitor, with a low number of patients needing treatment to achieve significant clinical improvements, though the overall effectiveness across these drugs was similar. These results support the use of IL-17 inhibitors as safe and effective options for managing AS over the long term, especially for patients who do not respond well to first-line treatments.
Conclusion:
IL-17 inhibitors demonstrate efficacy in improving disease activity, functional outcomes, and quality of life in patients with ankylosing spondylitis, alongside a consistent safety profile and minimal long-term structural progression. However, these agents are not first-line therapies due to their higher cost, potential for immune-related adverse events, and the established efficacy of other treatments. IL-17 inhibitors are recommended for patients with inadequate response or intolerance to first-line therapies, providing an effective alternative for achieving long-term disease control in refractory cases.
Recommended Citation
Sepulveda, Alyssa L.; Gutierrez, Yolanda V.; and Shaju, Ronald A., "Long-term Safety and Comparative Efficacy of IL-17 Inhibitors in Treating Ankylosing Spondylitis" (2025). Research Symposium. 4.
https://scholarworks.utrgv.edu/somrs/2025/posters/4
Included in
Biological Factors Commons, Immune System Diseases Commons, Pharmacy and Pharmaceutical Sciences Commons
Long-term Safety and Comparative Efficacy of IL-17 Inhibitors in Treating Ankylosing Spondylitis
Background:
Ankylosing Spondylitis (AS) is a chronic inflammatory disease affecting the axial skeleton, characterized by spinal stiffness, sacroiliitis, and potential vertebral fusion. While nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitors are first-line treatments, IL-17 inhibitors, such as secukinumab and ixekizumab, are used in patients with inadequate response or contraindications to TNF inhibitors. These targeted therapies address IL-17’s role in driving inflammation and structural damage in AS.
Methods:
A systematic review was conducted using PubMed, Science Direct, and Cochrane to identify studies published between 2000 and 2025. Keywords included “Ankylosing spondylitis” and “IL-17 inhibitors” and “efficacy.” Inclusion criteria focused on randomized controlled trials, observational studies, and meta-analyses reporting long-term outcomes, safety, and efficacy of IL-17 inhibitors in AS. Articles lacking primary data or focusing on other diseases were excluded. Initial search yielded 205 articles with 50 meeting the criteria.
Results:
IL-17 inhibitors, including secukinumab, ixekizumab, and netakimab, have shown significant effectiveness and safety in the long-term treatment of ankylosing spondylitis (AS). Secukinumab and ixekizumab improved the Assessment of SpondyloArthritis International Society 40% response (ASAS40) at Week 16, with response rates between 52% and 60.5%, and maintained these benefits over 1 to 5 years. Long-term response rates for ASAS40 and the Bath Ankylosing Spondylitis Disease Activity Index 50% response (BASDAI 50) were both above 60%. One clinical trial showed patients experienced improvements in spinal pain, physical function, and quality of life, with most showing sustained reductions in disease activity and little to no radiographic progression. In fact, over 93% of patients had no structural damage progression after 2 years. The safety profiles of IL-17 inhibitors were consistent, with the most common issues being mild infections and injection site reactions. Serious side effects, like severe infections or Crohn’s disease, were rare and manageable. Economic evaluations suggested netakimab as the most cost-effective IL-17 inhibitor, with a low number of patients needing treatment to achieve significant clinical improvements, though the overall effectiveness across these drugs was similar. These results support the use of IL-17 inhibitors as safe and effective options for managing AS over the long term, especially for patients who do not respond well to first-line treatments.
Conclusion:
IL-17 inhibitors demonstrate efficacy in improving disease activity, functional outcomes, and quality of life in patients with ankylosing spondylitis, alongside a consistent safety profile and minimal long-term structural progression. However, these agents are not first-line therapies due to their higher cost, potential for immune-related adverse events, and the established efficacy of other treatments. IL-17 inhibitors are recommended for patients with inadequate response or intolerance to first-line therapies, providing an effective alternative for achieving long-term disease control in refractory cases.
