The assessment of the drug retention rate of secukinumab in patients with psoriatic arthritis in a real-life multicentre cohort

Abstract

ObjectiveWe aimed to evaluate the drug retention rate (DRR) of secukinumab, an anti-IL-17A monoclonal antibody, in patients with psoriatic arthritis (PsA) in a real-life cohort, and to assess the impact of comorbidities and patient clinical characteristics on the DRR of secukinumab.Methods A retrospective study of prospective followed-up patients was performed to evaluate the DRR of secukinumab on patients with PsA attending the recruiting centres between January 2016 and June 2022. ResultsIn 207 patients with PsA, a 60-month DRR of secukinumab of 57.0% was estimated (mean time of administration of 21.5±17.1 months). Male gender, age ≥65 years, disease duration ≥5 years and ≥10 years did not influence the DRR of secukinumab. The presence of comorbidities, considering any concomitant disorder, did not affect the DRR of secukinumab. In patients with cardiometabolic multimorbidity, a trend toward a better DRR of secukinumab was recorded. In fact, patients with high blood pressure, dyslipidaemia, and type 2 diabetes showed a trend toward an improved DRR of secukinumab. Furthermore, the presence of obesity did not influence the DRR of secukinumab.Different dosages, previous bDMARDs, and concomitant therapy with csDMARDs did not influence the DRR of secukinumab. ConclusionA cumulative 60-month DRR of secukinumab of 57.0% in patients with PsA was retrieved. The presence of cardiometabolic multimorbidity could be associated with an improved DRR of secukinumab, whereas obesity did not affect this feature in our cohort. Previous bDMARDs, concomitant csDMARDs, and different drug dosages could not influence the DRR of secukinumab over time.

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.…”

“…The clinical picture of PsA may be complicated by comorbidities, which could make the management of these patients more di cult [44,45]. Regardless of the main disease, patients with comorbidities may be at higher risk of complications and mortality as well as less responsive to therapy, compared to patients with the same disease but without these conditions [29][30][31][32]46]. A considerable number of patients [508 (74.2%) out of 685 of our PsA population] had at least 1 comorbidity.…”

“…In the context of PsA, few studies have investigated the effectiveness and safety of secukinumab in a real-life setting both in Italian [21][22][23] and international cohorts [24][25][26], but only for a limited observational period. In addition, the impact of more lines of prior biologic (b) DMARDs, comorbidities, and clinical features on the achievement of clinical remission and on secukinumab drug survival has not yet been fully investigated [27][28][29][30][31][32][33].…”