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NCT02763046: ASTRUM

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

Completed Phase 4 Results posted Last updated 8 October 2021
What this trial tests

Phase 4 trial testing Secukinumab (AIN457) 150 mg s.c. in Ankylosing Spondylitis in 211 participants. Completed in 24 September 2019.

Timeline
31 May 2016
Primary endpoint
24 September 2019
24 September 2019

Quick facts

Lead sponsorNovartis Pharmaceuticals
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment211
Start date31 May 2016
Primary completion24 September 2019
Estimated completion24 September 2019
Sites39 locations across Germany

Drugs / interventions tested

Conditions studied

Sponsor

Novartis Pharmaceuticals — full company profile →

Who can join

18 and older, any sex, with Ankylosing Spondylitis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Proportion of Patients Who Achieved ASAS20 Response in the Pooled Secukinumab Group Compared With the Placebo Group at Week 12 Primary · Baseline, 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-re

GroupValue95% CI
Secukinumab - Pooled72
Placebo31
Proportion of Patients Who Achieved ASAS20 Response in Each Secukinumab Group (Delayed NSAID Tapering and Early NSAID Tapering) Compared With the Placebo Group Secondary · Baseline, Week 12, Week 16

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-re

Week 12
GroupValue95% CI
Secukinumab - Delayed NSAID Tapering37
Secukinumab - Early NSAID Tapering35
Placebo31
Week 16
GroupValue95% CI
Secukinumab - Delayed NSAID Tapering40
Secukinumab - Early NSAID Tapering35
Placebo29
Mean Change From Baseline in ASAS-NSAID Score at Week 12 Secondary · Baseline, 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 P

GroupValue95% CI
Secukinumab - Delayed NSAID Tapering-44.9± 47.32
Secukinumab - Early NSAID Tapering-40.3± 71.48
Placebo-31.5± 36.54
Secukinumab - Pooled-42.6± 60.53
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) Secondary · 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 P

GroupValue95% CI
Secukinumab - Delayed NSAID Tapering-44.9± 47.32
Secukinumab - Early NSAID Tapering-42.5± 68.62
Mean Change From Baseline in the BASDAI Total Score Secondary · Baseline, Week 12, Week 16

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 chan

Week 12
GroupValue95% CI
Secukinumab - Delayed NSAID Tapering-2.1± 2.16
Secukinumab - Early NSAID Tapering-2.0± 2.10
Placebo-1.8± 2.00
Secukinumab - Pooled-2.1± 2.12
Week 16
GroupValue95% CI
Secukinumab - Delayed NSAID Tapering-2.3± 1.90
Secukinumab - Early NSAID Tapering-2.0± 1.96
Placebo-1.7± 1.96
Secukinumab - Pooled-2.2± 1.93
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 Secondary · Baseline, Week 12

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 summe

GroupValue95% CI
Secukinumab - Delayed NSAID Tapering4.8± 7.03
Secukinumab - Early NSAID Tapering6.1± 6.92
Placebo4.8± 7.43
Secukinumab - Pooled5.5± 6.98

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were collected from first dose of study treatment until end of study treatment plus 4 weeks post-treatment (median duration of 24 weeks).. Reporting threshold: 1%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Secukinumab - Delayed NSAID Tapering - Treatment Period 1
Serious: 4/71 (6%)
Deaths: 0/71
Secukinumab - Early NSAID Tapering - Treatment Period 1
Serious: 3/70 (4%)
Deaths: 0/70
Placebo - Treatment Period 1
Serious: 1/70 (1%)
Deaths: 0/70
Secukinumab - Delayed NSAID Tapering - Treatment Period 2
Serious: 1/71 (1%)
Deaths: 0/71
Secukinumab - Early NSAID Tapering - Treatment Period 2
Serious: 0/70 (0%)
Deaths: 0/70
Placebo - Treatment Period 2
Serious: 1/70 (1%)
Deaths: 0/70

Serious adverse events (12 terms)

ReactionSystemSecukinumab - Delayed NSAI…Secukinumab - Early NSAID …Placebo - Treatment Period 1Secukinumab - Delayed NSAI…Secukinumab - Early NSAID …Placebo - Treatment Period 2
IridocyclitisEye disorders
Abdominal herniaGastrointestinal disorders
Abdominal painGastrointestinal disorders
ColitisGastrointestinal disorders
Crohn's diseaseGastrointestinal disorders
GastritisGastrointestinal disorders
Inguinal herniaGastrointestinal disorders
Oesophageal ulcerGastrointestinal disorders
ErysipelasInfections and infestations
NephrolithiasisRenal and urinary disorders
Vaginal cystReproductive system and breast disorders
PsoriasisSkin and subcutaneous tissue disorders
Other adverse events (232 terms — click to expand)

ReactionSystemSecukinumab - Delayed NSAI…Secukinumab - Early NSAID …Placebo - Treatment Period 1Secukinumab - Delayed NSAI…Secukinumab - Early NSAID …Placebo - Treatment Period 2
NasopharyngitisInfections and infestations
HeadacheNervous system disorders
Ankylosing spondylitisMusculoskeletal and connective tissue disorders
NauseaGastrointestinal disorders
BronchitisInfections and infestations
GastroenteritisInfections and infestations
Respiratory tract infectionInfections and infestations
RhinitisInfections and infestations
Back painMusculoskeletal and connective tissue disorders
HypertensionVascular disorders
VertigoEar and labyrinth disorders
Abdominal painGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
DyspepsiaGastrointestinal disorders
Upper respiratory tract infectionInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
PruritusSkin and subcutaneous tissue disorders
RashSkin and subcutaneous tissue disorders
Dry mouthGastrointestinal disorders
FatigueGeneral disorders
ConjunctivitisInfections and infestations
Oral herpesInfections and infestations
Pulpitis dentalInfections and infestations
SinusitisInfections and infestations
Blood glucose increasedInvestigations
Weight decreasedInvestigations
ArthralgiaMusculoskeletal and connective tissue disorders
Musculoskeletal chest painMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Spinal painMusculoskeletal and connective tissue disorders
SpondylitisMusculoskeletal and connective tissue disorders
SpondyloarthropathyMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
ParaesthesiaNervous system disorders
RhinorrhoeaRespiratory, thoracic and mediastinal disorders
ErythemaSkin and subcutaneous tissue disorders
HyperhidrosisSkin and subcutaneous tissue disorders
AnaemiaBlood and lymphatic system disorders

Most-reported serious reactions: Iridocyclitis, Abdominal hernia, Abdominal pain, Colitis, Crohn's disease, Gastritis, Inguinal hernia, Oesophageal ulcer.

Data from ClinicalTrials.gov NCT02763046 adverse events section.

Sponsor's own description

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.

Publications & conference data

5 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Efficacy and safety of interleukin-17A inhibitors in patients with ankylosing spondylitis: a systematic review and meta-analysis of randomized controlled trials.
    Wang P, Zhang S, Hu B, Liu W, et al · · 2021 · cited 15× · PMID 33432451 · DOI 10.1007/s10067-020-05545-y
  2. Anti-IL17A in Axial Spondyloarthritis-Where Are We At?
    Cheung PP. · · 2017 · cited 15× · PMID 28149838 · DOI 10.3389/fmed.2017.00001
  3. Matching-Adjusted Indirect Comparison of the 52-Week Efficacy of Bimekizumab Versus Secukinumab and Ixekizumab for the Treatment of Radiographic Axial Spondyloarthritis.
    Maksymowych WP, Thom H, Mørup MF, Taieb V, et al · · 2024 · cited 6× · PMID 38916823 · DOI 10.1007/s40744-024-00684-z
  4. Interleukin-17 Inhibitors for the Treatment of Ankylosing Spondylitis.
    Huang JX, Zhang LJ, Wei JC. · · 2020 · cited 4× · PMID 36465082 · DOI 10.2478/rir-2020-0004
  5. Efficacy and NSAID-sparing effect of secukinumab 150 mg in ankylosing spondylitis: results from phase IV ASTRUM study.
    Kiltz U, Baraliakos X, Brandt-Jürgens J, Wagner U, et al · · 2024 · PMID 38846755 · DOI 10.1177/1759720x241255486

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02763046.

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