Background/Aims
Interleukin-17 inhibitors (anti-IL-17) have provided an additional treatment option in psoriatic arthritis (PsA). This study aims to describe the patient profile, treatment patterns and persistence in PsA patients treated with ixekizumab and secukinumab in a real-life setting.
Methods
A multicentre, retrospective study was conducted at 8 Spanish hospitals. Three cohorts of adult PsA patients, newly initiating treatment with an anti-IL-17A (secukinumab 150mg [SECU150], secukinumab 300mg [SECU300], ixekizumab [IXE]), between January 2019 and March 2020 were included. Data of patients exposed to anti-IL-17 drugs with a follow-up visit were collected until March 2021. Demographic and clinical characteristics, treatment patterns, and persistence were analysed descriptively. Continuous data were presented as mean (standard deviation [SD]) and categorical variables as frequencies with percentage. Persistence rates at 3/6/12 months were calculated.
Results
A total of 221 PsA patients were analysed (SECU150: 103 [46.6%], SECU300: 38 [17.2%] and IXE: 80 [36.2%]). Treatment patterns differed by clinical characteristics: SECU150 patients presented more moderate PsA and less peripheral joint damage, while SECU300 patients included a higher rate of enthesitis and active psoriasis. IXE patients showed a longer time since PsA diagnosis, with more frequent co-morbidities, joint damage and psoriasis diagnosed. 77.8% of patients were previously treated with csDMARDs in monotherapy and 72.9% with bDMARDs/tsDMARDs (93.8% IXE, 68.4% SECU300 and 58.3% SECU150). Mean number of previous bDMARDS/tsDMARDS were 2.4 (1.5), 1.7 (0.9) and 1.6 (1.0), respectively. Overall, persistence to anti-IL-17 treatments was found in 97.2%, 88.4% and 81.0% of patients at 3, 6 and 12 months, respectively, being 83.1% for SECU150, 64.5% for SECU300 and 86.4% for IXE at one year. The most frequent reason for discontinuation was lack of effectiveness (13.8%).
Conclusion
Most PsA patients treated with anti-IL-17 in Spain had a moderate to severe disease, high peripheral joint damage and skin involvement and had received at least 1 previous bDMARD/tsDMARD. More than 80% of patients with one year follow-up were persistent to anti-IL-17 treatments, observing the highest rate with IXE, followed by SECU150 and SECU300.
Disclosure
B. Ibañez: Consultancies; B.J.I. has received consulting fees from UCB, AMGEN, JANSSEN. Honoraria; B.J.I. has received honoraria from ABBVIE, LILLY, JANSSEN, NOVARTIS. Other; B.J.I. has received support for attending meetings and/or travel from NOVARTIS, UCB. C. Manteca: Other; C.F.M. has received support for attending meetings and/or travel from Inscripcion on line Congreso SER, EULAR. E. Rubio: None. E. Raya: None. A. Pérez-Linaza: None. R. Hernandez: Honoraria; R.H. has received honoraria from Lilly, Novartis, Janssen, Pfizer, Abbie. Grants/research support; R.H. has received support for the present manuscript from Lilly. Other; R.H. has received fee for expert testimony from Novartis, R.H. has received support for attending meetings and/or travel from NOVARTIS, UCB, R.H. has received fee for participation on a Data Safety Monitoring Board or Advisory Board from Novartis. S. Manrique-Arija: None. M. Núñez: Shareholder/stock ownership; M.N. is an employee and minor shareholder in Lilly. Grants/research support; M.N. has received support for the present manuscript from Lilly. S. Diaz: Shareholder/stock ownership; S.D. is an employee and minor shareholder in Lilly. Grants/research support; S.D. has received support for the present manuscript from Lilly. L. Trancho: Shareholder/stock ownership; L.T. is an employee and minor shareholder in Lilly. Grants/research support; L.T. has received support for the present manuscript from Lilly. R. García de Vicuña: Consultancies; R.G.D.V. has received consulting fees from Abbvie, Pfizer, Biogen, MSD. Honoraria; R.G.D.V. has received honoraria from Pfizer, Novartis, Sandoz. Grants/research support; R.G.D.V. has received funding for research from from Lilly, Novartis, Abbvie, Janssen, MSD, UCB. Other; R.G.D.V. has received support for attending meetings and/or travel from Abbvie, Pfizer, Novartis, MSD, Janssen, Lilly, UCB. A. Kiprianos (Non-author Presenter): Shareholder/stock ownership; A.P. is an employee and minor shareholder in Eli Lilly and Company.
