In patients with psoriatic arthritis (PsA) receiving secukinumab, retention, remission, low disease activity (LDA), and response rates were significantly better for those who were bionaive after 6 and 12 months of treatment, according to study results published in Arthritis Care & Research (Hoboken). Researchers indicated high retention rates and good remission, LDA, and response rates of secukinumab, with overall effectiveness comparable to previous observational studies of tumor necrosis factor inhibitors.
Researchers sought to evaluate the overall real-life 12-month retention rates of secukinumab in European patients with PsA.
A longitudinal, observational study was conducted in 13 quality registries in rheumatology practices in the European Spondyloarthritis Research Collaboration Network (EuroSpA RCN).
The current study included data from patients with PsA who received secukinumab between May 2015 and December 2018 in 13 countries in EuroSpA RCN, including Sweden, Denmark, Switzerland, Italy, Spain, Czech Republic, Slovenia, Portugal, Norway, Finland, Iceland, Romania, and Turkey. Study inclusion criteria were participants aged at least 18 years at beginning of treatment, a PsA diagnosis according to a treating rheumatologist, and a registered start and, if relevant, stop date of receiving secukinumab.
The primary study outcome was overall 12-month secukinumab retention rates. Secondary study outcomes included overall 6-month retention rates, as well as remission, LDA, and response rates after 6 months and 12 months of treatment.
A total of 2017 patients with PsA who had received secukinumab for the first time were enrolled in the study. After 6 and 12 months of secukinumab, overall retention rates were 86% and 76%, respectively. Crude (LUNDEX-adjusted) 6-month remission/LDA rates for Disease Activity Index for Psoriatic Arthritis (DAPSA28), 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP), and Simplified Disease Activity Index (SDAI) were 13%/46% (11%/39%), 36%/55% (30%/46%), and 13%/56% (11%/47%), respectively. At 12 months, crude (LUNDEX-adjusted) remission/LDA rates for DAPSA28, DAS28-CRP, and SDAI were 11%/46% (7%/31%), 39%/56% (26%/38%), and 16%/62% (10%/41%), respectively.
At 6 months, crude (LUNDEX-adjusted) American College of Rheumatology (ACR) 20/50/70 responses were 34%/19%/11% (29%/16%/9%), respectively. At 12 months, crude (LUNDEX-adjusted) ACR20/50/70 responses were 37%/21%/11% (24%/14%/7%). Further, the effectiveness of secukinumab was significantly better among biologic/targeted synthetic disease-modifying antirheumatic drug (b/ts DMARD)-naive patients and was similar over time since PsA diagnosis (<2 years, 2-4 years, and >4 years), varying significantly across the European registries.
Study limitations included lack of data on extra-articular inflammatory involvement, heterogeneity in baseline characteristics and secukinumab effectiveness across the registries, and missing data on disease states and response rates, which reduced generalizability of the findings.
Researchers concluded that the findings from this study may be taken into consideration when making treatment decisions in routine clinical care.
Disclosure: The EuroSpA collaboration was supported by Novartis. Please see the original reference for a full list of authors’ disclosures.
Michelsen B, Georgiadis S, Di Giuseppe D, et al. Real-world 6 and 12-month drug retention, remission and response rates of secukinumab in 2,017 psoriatic arthritis patients in 13 European countries. Arthritis Care Res (Hoboken). Published online January 18, 2021. doi:10.1002/acr.24560