Secukinumab for treating active ankylosing spondylitis

Secukinumab is recommended, within its marketing authorisation, as an option for treating active ankylosing spondylitis that is not controlled well enough with conventional treatments in adults, only if:

• the condition has a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of 4 units or more and a spinal visual analogue scale (VAS) of 4 cm or more

• tumour necrosis factor-alpha inhibitors are not suitable or have not controlled the condition well enough, and

• the company provides tofacitinib according to the commercial arrangement.

Assess the response to secukinumab after 16 weeks of treatment and only continue if there is clear evidence of response, defined as:

• a reduction in the BASDAI score to 50% of the pre-treatment value or by 2 or more units and

• a reduction in the VAS by 2 cm or more.

When using BASDAI and spinal pain VAS scores, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect the responses to the questionnaires, and make any adjustments they consider appropriate.