Efficacy and Safety of Golimumab in Patients With Ankylosing Spondylitis Results of a Randomized, Double-Blind, Placebo-Controlled, Phase III Trial

Objective. To evaluate the efficacy and safety of golimumab in patients with ankylosing spondylitis (AS) in the GO-RAISE study. Methods. Patients with active AS, a Bath AS Disease Activity Index (BASDAI) score >= 4, and a back pain score of >= 4 were randomly assigned in a 1.8:1.8:1 ratio to receive subcutaneous injections of golimumab (50 mg or 100 mg) or placebo every 4 weeks. The primary end point was the proportion of patients with at least 20% improvement in the Assessment in AS (ASAS20) criteria at week 14. Results. At randomization, 138, 140, and 78 patients were assigned to the 50-mg, 100-mg, and placebo groups, respectively. After 14 weeks, 59.4%, 60.0%, and 21.8% of patients, respectively, were ASAS20 responders (P < 0.001). A 40% improvement in the ASAS criteria at week 24 occurred in 43.5%, 54.3%, and 15.4% of patients, respectively. Patients receiving golimumab also showed significant improvement in the physical and mental component summary scores of the Short Form 36 Health Survey, the Jenkins Sleep Evaluation Questionnaire score, the BASDAI score, and the Bath AS Functional Index score, but not the Bath AS Metrology Index score. Through week 24, 85.6% of golimumab-treated patients and 76.6% of patients in the placebo group had >= 1 adverse event, and 5.4% and 6.5% of patients, respectively, had >= 1 serious adverse event. Eight golimumab-treated patients and 1 placebo-treated patient had markedly abnormal liver enzyme values (>= 100% increase from baseline and a value >150 IU/liter), which were transient. Conclusion. Golimumab was effective and well tolerated in a large cohort of patients with AS during a 24-week study period.