PURPOSE: To determine the efficacy and safety of different doses of secukinumab, 
a fully human monoclonal antibody for targeted interleukin-17A blockade, in 
patients with noninfectious uveitis.
DESIGN: Three multicenter, randomized, double-masked, placebo-controlled, 
dose-ranging phase III studies: SHIELD, INSURE, and ENDURE.
PARTICIPANTS: A total of 118 patients with Behçet's uveitis (SHIELD study); 31 
patients with active, noninfectious, non-Behçet's uveitis (INSURE study); and 
125 patients with quiescent, noninfectious, non-Behçet's uveitis (ENDURE study) 
were enrolled.
METHODS: After an initial subcutaneous (s.c.) loading phase in each treatment 
arm, patients received s.c. maintenance therapy with secukinumab 300 mg every 2 
weeks (q2w), secukinumab 300 mg monthly (q4w), or placebo in the SHIELD study; 
secukinumab 300 mg q2w, secukinumab 300 mg q4w, secukinumab 150 mg q4w, or 
placebo in the INSURE study; or secukinumab 300 mg q2w, secukinumab 300 mg q4w, 
secukinumab 150 mg q4w, or placebo in the ENDURE study.
MAIN OUTCOME MEASURES: Reduction of uveitis recurrence or vitreous haze score 
during withdrawal of concomitant immunosuppressive medication (ISM). Other end 
points included best-corrected visual acuity, ISM use (expressed as a 
standardized ISM score), and safety outcomes.
RESULTS: After completion or early termination of each trial, there were no 
statistically significant differences in uveitis recurrence between the 
secukinumab treatment groups and placebo groups in any study. Secukinumab was 
associated with a significant reduction in mean total post-baseline ISM score (P 
= 0.019; 300 mg q4w vs. placebo) in the SHIELD study. Likewise, secukinumab was 
associated with a greater median reduction in ISM score versus placebo in the 
INSURE study, although no statistical analysis of the difference was conducted 
because of the small sample size. Overall, there was no loss in visual acuity 
reported in any treatment group during follow-up in all 3 studies. According to 
descriptive safety statistics, the frequencies of ocular and nonocular adverse 
events seemed to be slightly higher among secukinumab groups versus placebo 
across the 3 studies.
CONCLUSIONS: The primary efficacy end points of the 3 studies were not met. The 
secondary efficacy data from these studies suggest a beneficial effect of 
secukinumab in reducing the use of concomitant ISM.