Biological disease-modifying antirheumatic drugs for nonradiographic axial spondyloarthritis

Recent data support the efficacy of biological disease-modifying antirheumatic drugs (bDMARDs) in severe nonradiographic axial spondyloarthritis that is unresponsive to nonpharmacological management and NSAIDs, particularly in people with objective markers of inflammation (elevated erythrocyte sedimentation rate [ESR] or serum C-reactive protein [CRP] concentration, or ‘bone oedema’ on magnetic resonance imaging [MRI])1.

The usual dosages of bDMARDs that are listed on the PBS for nonradiographic axial spondyloarthritis (in alphabetical order) are:

bimekizumab 160 mg subcutaneously, every 4 weeks bimekizumab bimekizumab bimekizumab

OR

certolizumab pegol 400 mg subcutaneously, as a single dose at 0, 2 and 4 weeks, then 200 mg subcutaneously, every 2 weeks thereafter certolizumab pegol certolizumab pegol certolizumab pegol

OR

certolizumab pegol 400 mg subcutaneously, as a single dose at 0, 2 and 4 weeks, and thereafter every 4 weeks certolizumab pegol certolizumab pegol certolizumab pegol

OR

golimumab 50 mg subcutaneously, every 4 weeks golimumab golimumab golimumab

OR

secukinumab 150 mg subcutaneously, as a single dose at 0, 1, 2, 3 and 4 weeks, and thereafter every 4 weeks. secukinumab secukinumab secukinumab

1 There are data to support the use of targeted-synthetic disease-modifying antirheumatic drugs (tsDMARDs) for patients with severe nonradiographic axial spondyloarthritis; however, at the time of writing these are not available on the PBS; see the PBS website for current information.Return