Objective. This study assessed the efficacy and safety of secukinumab and adalimumab in patients with active ankylosing spondylitis (AS). Methods. A Bayesian network meta-analysis was performed with direct and indirect data collected from randomized controlled trials (RCTs) of efficacy and safety of secukinumab 75 mg, 150 mg and adalimumab 40 mg in patients with active AS. Results. Five RCTs (1,483 patients) met the inclusion criteria. The Assessment in Spondyloarthritis International Society response criteria of ≥20% (ASAS20) response rate was significantly higher in the adalimumab 40 mg (Odds ratio [OR], 4.26; 95% credible interval [CrI], 2.09∼8.08), secukinumab 150 mg (OR, 3.35; 95% CrI, 1.73∼6.56), and 75 mg dose (OR, 2.44; 95% CrI, 1.06∼5.05) than with placebo. The ranking probability based on the surface under the cumulative ranking curve (SUCRA) indicated that adalimumab 40 mg had the highest probability of being the best treatment for achieving an ASAS20 response (SUCRA=0.8753), followed by secukinumab 150 mg (SUCRA=0.7051), secukinumab 75 mg (SUCRA=0.4113), and placebo (SUCRA=0.0083). The ASAS40 response rate distribution pattern was similar to the ASAS20 response rate. However, the number of serious adverse events did not differ significantly among the treatment options. Conclusion. Secukinumab and adalimumab were effective for the treatment of active AS without causing a significant risk of serious adverse events.

Keywords: Secukinumab, Adalimumab, Ankylosing spondylitis, Network meta-analysis