Presentation (CTI)

OBJECTIVES: To compare the long-term efficacy of IL-17 inhibitor netakimab (NTK) with other registered in the Russian Federation biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) for r-axSpA over a 3-year horizon.
METHODS: For NTK, individual patient data (IPD) from the randomized controlled trial (RCT) ASTERA were used. For comparators: TNFα inhibitors (adalimumab, infliximab, golimumab, etanercept, certolizumab pegol), IL-17 inhibitors (secukinumab, ixekizumab), JAK inhibitors (tofacitinib, upadacitinib), 11 RCTs were selected via systematic literature search conducted in PubMed and Embase on February 26, 2026. Unanchored simulated treatment comparisons (STC) were employed with longitudinal regression models for ASAS 40, ASAS 20, BASDAI 50, ASDAS-ID, ASDAS-LDA, ASDAS-CII, ASDAS-MI endpoints, incorporating covariates for age, sex, baseline BASDAI, ASDAS, C-reactive protein, disease duration since diagnosis, and HLA-B27 status. IPD for comparators' populations were synthesized using NORTA. Marginal risk differences (RD) with 95% bootstrap confidence intervals (CI) were used as estimands.
RESULTS: Adjusted RD (95% CI) for ASAS 40 on NTK vs all comparators approved in Russian Federation: adalimumab (156W) 17.5 (5.8; 29.2), infliximab (156W) 31.1 (17.0; 45.2), golimumab (104W) 21.5 (9.9; 33.0), etanercept (52W) 18.3 (1.8; 34.9), certolizumab pegol (156W) 17.5% (3.0; 32.0), secukinumab (156W) 17.7 (2.0; 33.4), ixekizumab (COAST-V, 156W) 32.6 (18.3; 46.8), ixekizumab (COAST-W, 156W) 47.4 (34.5; 60.3), tofacitinib (48W) 21.7 (9.5; 33.8), upadacitinib (104W) -9.0 (-22.5; 4.5). Similar superiority patterns were detected for secondary endpoints.
CONCLUSIONS: NTK demonstrates superior long-term efficacy over all registered TNFα inhibitors, IL-17 inhibitors (except comparable performance with upadacitinib), and tofacitinib by achieving ASAS40 response in patients with active r-axSpA.