Objective:

To identify subgroups of patients with active ankylosing spondylitis (AS) exhibiting homogeneous treatment response patterns to adalimumab (ADA) and its biosimilar using consensus clustering analysis.

Approach:

Key Findings:

• C2 was characterized by older age (mean age 52 vs. 38), longer disease duration (mean 12 vs. 6 years), and more prior TNFi exposure (60% vs. 30%) compared to C1.
• C1 achieved significantly higher rates of ASDAS-Inactive Disease at week 2 (21% vs. 1%, p < 0.001) and week 24 (63% vs. 14%, p < 0.001).

Interpretation:

The study provides a framework for early patient stratification based on treatment response patterns.

Limitations:

• The findings require further independent validation for prospective clinical application.
• The study is based on a post-hoc analysis of a randomized controlled trial, which may limit generalizability.

Conclusion:

Distinct response trajectories were observed, suggesting the potential for early identification of treatment response subtypes in active AS.

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