Early divergence of treatment response trajectories to adalimumab or its biosimilar in active ankylosing spondylitis: consensus clustering analysis of a randomized controlled trial - Report - MDSpire
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Early divergence of treatment response trajectories to adalimumab or its biosimilar in active ankylosing spondylitis: consensus clustering analysis of a randomized controlled trial
Clinical Report: Differential Patterns of Treatment Response to Adalimumab
Overview
This study identifies two distinct response clusters among patients with active ankylosing spondylitis (AS) receiving adalimumab or its biosimilar.
Background
Ankylosing spondylitis (AS) is a chronic inflammatory condition that shows variability in treatment responses to tumor necrosis factor alpha inhibitors (TNFi). Understanding these response patterns is crucial for optimizing treatment strategies. This study employs consensus clustering to explore treatment response heterogeneity in AS patients.
Data Highlights
Cluster
Number of Patients
Response Rate at Week 2
Response Rate at Week 24
C1 (Favorable)
246 (56.2%)
0.21 (95% CI 0.16, 0.26)
0.63 (95% CI 0.57, 0.69)
C2 (Less Favorable)
192 (43.8%)
0.01 (95% CI 0.00, 0.02)
0.14 (95% CI 0.09, 0.18)
Key Findings
Two clusters identified: favorable-response (C1) and less favorable-response (C2).
C2 patients were older, had longer disease duration, and more prior TNFi exposure compared to C1.
Significant divergence in clinical endpoints emerged as early as week 2 and persisted through week 24.
C1 achieved significantly higher rates of ASDAS-Inactive Disease at both week 2 and week 24 compared to C2.
A multivariable model had a C-statistic of 0.880 for identifying C2 based on baseline and week-2 data.
Clinical Implications
Further validation is necessary to determine the clinical utility of these findings.
Conclusion
This study provides insights into the heterogeneous treatment responses in AS patients receiving adalimumab.
The procedure was performed under a HOPE Act research protocol at an NYU Langone Health center the institution said is among the limited number of US transplant centers equipped and approved to perform HOPE lung transplants.
