Spondyloarthritis & psoriatic arthritis
Effect of secukinumab dose escalation on MRI-detected inflammation and structural damage in axial spondyloarthritis: a clinical, investigator-initiated, treat-to-target study (TRACE)
Authors' conclusion
No statistically significant effect of secukinumab dose escalation on reducing MRI-detected inflammation was observed, except in a selected subgroup of patients.
Study context
- Population
- Biologic-naïve patients with active axial spondyloarthritis (axSpA)68% male
- Participants
- 90 patients
- Comparison
- Week 16 Axial Spondyloarthritis Disease Activity Score (ASDAS) remitters continuing secukinumab 150 mg vs week 16 non-remitters escalated to 300 mg/month
- Week 16 remittersn = 30
- Outcome
- Total MRI-inflammation improvement ≥2 (weeks 16-24), week 16 remitters vs week 16 non-remitters
- Follow-up
- Weeks 16-24
Methodological detailsmulticentre, clinical
- Multicentre
- Clinical
Main finding
As reported in the abstract
Total MRI-inflammation improvement ≥2
P = 0.53
Further findings
Mean
| Outcome | Dose-escalation responders | Dose-escalation non-responders |
|---|---|---|
| Mean total MRI inflammation reduction by dose-escalation responseNumerically larger | −6.1 | −2.2 |
ASDAS remission · week 24
- Patients in ASDAS remission
- 36 (49%)
- Week 16 non-remitters in remission after dose escalation (dose-escalation responders)
- 10 (22%)
Total MRI inflammation (Spondyloarthritis Research Consortium of Canada (SPARCC) spine+sacroiliac joint (SIJ)), reduction · week 4
- Marked reduction in total MRI inflammation, with structural lesion remodelling (reduced SIJ erosion; increased SIJ fat and backfill)
- −14.7
Original publication
Effect of secukinumab dose escalation on MRI-detected inflammation and structural damage in axial spondyloarthritis: a clinical, investigator-initiated, treat-to-target study (TRACE). RMD Open. Published 10 April 2026. doi:10.
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