Association of Gender, Diagnosis, and Obesity With Retention Rate of Secukinumab in Spondyloarthropathies: Results Form a Multicenter Real-World Study

Abstract

Background: Secukinumab has been shown effective for psoriatic arthritis (PsA) and axial spondylarthritis (AxSpA) in randomized trials. The aim of this study was to analyze baseline patient and disease characteristics associated with a better retention rate of secukinumab under real-world conditions.Patients and Methods: Real-life, prospective multicenter observational study involving 138 patients, 61 PsA and 77 AxSpA, who were analyzed at baseline, 6, 12 months and subsequently every year after starting secukinumab regardless of the line of treatment. Demographics and disease characteristics, measures of activity, secukinumab use, and adverse events were collected. Drug survival was analyzed using Kaplan-Meier curves and factors associated with discontinuation were evaluated using Cox regression. The machine-learning J48 decision tree classifier was also applied.Results: During the 1st year of treatment, 75% of patients persisted with secukinumab, but accrued 71% (n = 32) in total losses (n = 45). The backward stepwise (Wald) method selected diagnosis, obesity, and gender as relevant variables, the latter when analyzing the interactions. At 1 year of follow-up, the Cox model showed the best retention rate in the groups of AxSpa women (95%, 95% CI 93–97%) and PsA men (89%, 95% CI 84–93%), with the worst retention in PsA women (66%, 95% CI 54–79%). The J48 predicted secukinumab retention with an accuracy of 77.2%. No unexpected safety issues were observed.Conclusions: Secukinumab shows the best retention rate at 1 year of treatment in AxSpA women and in PsA men, independently of factors such as the time of disease evolution, the line of treatment or the initial dose of the drug.

Four-year effectiveness, safety and drug retention rate of secukinumab in psoriatic arthritis: a real-life Italian multicenter cohort

“…In our study population, the drug's safety pro le was good (only 41 cases leading to drug withdrawal due to adverse events). Although this low incidence of adverse events might be linked to the fact that minor side effects may not be reported in a real-life setting, this frequency was consistent with previous real-life reports [22,24,25,31,32,33,43]. A pooled safety analysis from a phase III RCT supports the favorable long-term safety of secukinumab in patients with psoriasis and PsA [15].…”

“…Furthermore, in our study MDA was achieved in 65.6% at T24, and this proportion increased to 70.9% at T48; similarly, 36.7% and 43.1% of patients achieved DAPSA-REM and DAPSA-LDA at T24, respectively, and this state was maintained or improved at T48 (DAPSA-REM in 50% and DAPSA-LDA in 39.6%). Higher MDA and DAPSA response rates were also observed in the naïve group vs. the non-naïve group, in line with RCT data [12,14,18] and real-life experiences [22,24,25,31,32,33,43]. In this sense, the results for the sustained effectiveness of secukinumab presented here, regardless of biologic treatment line, highlight that therapy with this drug is appropriate both in non-naïve patients with an inadequate response or intolerant to previous TNF inhibitors (TNFi), and in biologic-naïve patients.…”

Factors associated with the retention of secukinumab in patients with axial spondyloarthritis in real-world practice: results from a retrospective study (FORSYA)

“…The previously reported 1-year retention rate of secukinumab in real-world settings was in the range of 61%–79% in both axSpA and PsA patients 17 19 20 31. In comparison to these findings, retention rate in the current study was slightly lower, presumably because large proportion of patients received secukinumab as ≥third line of therapy.…”

“…RWE studies provide valuable data on the predictive factors for retention, safety and survival of secukinumab in a heterogeneous French patient population with comorbidities, which is not commonly reported in the RCT. Furthermore, the study enrolled a larger patient population than previously published studies 17 19 31…”

“…16 Under real-world conditions, drug retention provides critical information on efficacy, safety, compliance and convenience of use. The retention of secukinumab has been evaluated in retrospective observational series and registries [17][18][19][20][21][22] including axSpA. 20 23 24 Although the factors influencing anti-TNF efficacy and retention in axSpAsuch as smoking status, young age, gender, human leucocyte antigen (HLA)-B27 positivity, radiographic status, objective signs of inflammation (OSI) and rank of drug administration-have been identified in various RCTs and RWE studies, [25][26][27] data on anti-IL17 agents are sparse.…”