What the trial was testing
The COAST-W enrolled 316 patients with axial spondyloarthritis. The study was sponsored by Eli Lilly and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
25–31% of patients who had already stopped responding to prior biologics still improved meaningfully on ixekizumab.
Arthritis & Rheumatology · 2019 · NCT02696798
These findings — that rate of meaningful improvement vs placebo (25–31% vs 12.5%) in patients who had stopped responding to prior biologic treatment — were published in the Arthritis & Rheumatology and represent the headline result of the study.
Researchers tracked outcomes across 316 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with axial spondyloarthritis, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
Ixekizumab (Taltz) is FDA-approved for ankylosing spondylitis, including for patients who have not responded to TNF inhibitors. If your current biologic has stopped working, ask your rheumatologist whether switching to an IL-17 inhibitor makes sense for you.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open axial spondyloarthritis trials
A Study to Assess the Concentration of Bimekizumab in Mature Breast Milk From Mothers Receiving Treatment With Bimzelx® (Bimekizumab)
Primary purpose of the study is to assess the concentration of bimekizumab in mature human breast milk.
German Spondyloarthritis Inception Cohort
The German Spondyloarthritis Inception cohort (GESPIC) was started 2000 as a prospective, longitudinal, multicentre, nationwide study in Germany on patients with early SpA including ankylosing spondylitis (AS, also known as radiographic axial spondyloarthritis) and non-radiographic axial SpA. The objectives of GESPIC are to learn about the course of SpA during the very early stage of the disease, to appropriately assess the outcome including radiographic progression of patients after several years of follow-up, to identify outcome predictors, to assess quality of life, function, and costs (direct and indirect costs). GESPIC has been recently expanded to recruit patients with other forms of SpA / conditions associated with SpA: acute anterior uveitis, Crohn's disease as well as with psoriasis / axial psoriatic arthritis.