Article
作者: Wang, Xiaoxia ; Sun, Hongsheng ; Jin, Jingchun ; Li, Tianwang ; Zhao, Yi ; Wei, Hua ; Fan, Wenqiang ; Jiang, Zhenyu ; Zhang, Chunyan ; Hao, Jie ; Qian, Long ; Zhou, Dongmei ; Yuan, Guohua ; Hu, Jiankang ; Xu, Dong ; Yang, Jing ; Gu, Jieruo ; Li, Xiaomei ; Fan, Xiaoyun ; Xu, Jian ; Sun, Li ; Xu, Baijie ; Liu, Ju ; Da, Zhanyun ; Qin, Li ; Cai, Xiaoyan ; Sun, Lingyun ; Liu, Shengyun ; Yuan, Fenghong ; Jiang, Tao ; Gou, Wei ; Zeng, Xiaofeng ; Yang, Min ; Li, Shujie ; Wang, Wei ; Dai, Lie ; Zhang, Shangzhu ; Zhang, Hua ; Kong, Ning ; Dong, Lingli ; Zhang, Ning ; Shu, Qiang
BACKGROUND:Xeligekimab is a novel immunoglobulin G4 (IgG4) monoclonal antibody targeting interleukin-17A (IL-17A). In a phase III trial in patients with plaque psoriasis, xeligekimab showed efficacy and safety consistent with other IL-17A inhibitors, supporting its potential application in the treatment of spondyloarthritis.
OBJECTIVE:This phase III trial aimed to investigate the efficacy and safety of xeligekimab in patients with radiographic axial spondyloarthritis (r-axSpA).
METHODS:This was a phase III study conducted at multiple centers in China. Eligible patients were randomly assigned (1:1:1) to receive xeligekimab 100 mg, xeligekimab 200 mg, or placebo. Randomization was stratified by medication history (biologic-experienced vs. biologic-naïve) and weight (≥ 70 kg vs. < 70 kg). The primary endpoint was the proportion of patients achieving an Assessment of SpondyloArthritis International Society 20 (ASAS20) response at week 16. A key secondary endpoint was the ASAS40 response rate at the same time point.
RESULTS:A total of 465 patients were recruited. A significantly higher proportion of patients receiving xeligekimab 200 mg (n = 114 (74.0%); p < 0.001, 95% confidence interval (CI) 28.5-48.4) and xeligekimab 100 mg (n = 102 (65.8%); p < 0.001, 95% CI 19.4-41.0) achieved an ASAS20 response compared to the placebo group (n = 56 (35.9%)) at week 16. Similarly, a significantly higher ASAS40 response rate was observed in the xeligekimab 100 mg group (n = 62 (40.0%); p < 0.001) and the xeligekimab 200 mg group (n = 64 (41.6%); p < 0.001) compared to placebo. Adverse events were similar across all groups, with serious adverse events occurring in 1.6% of the treatment group during the core treatment period. No unexpected safety signals were reported through week 48.
CONCLUSION:Xeligekimab demonstrated significant efficacy in improving the signs and symptoms of active r-axSpA in Chinese patients at week 16, with sustained effects observed through week 48 and no new safety signals identified.
TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT05881785 (Date: 21 May 2023).