2199: Four-year Secukinumab Treatment Outcomes in Axial Spondyloarthritis and Psoriatic Arthritis Patients Treated in Routine Care: Results from the EuroSpA Collaboration

Marion Pons¹, Stylianos Georgiadis¹, Zohra Faizy Ahmadzay², Mikkel Østergaard³, Bente Glintborg¹, Jette Heberg¹, Sara Nysom Christiansen¹, Simon Horskjær Rasmussen¹, Isabel Castrejon⁴, Fernando Alonso⁵, Karin Laas⁶, Sigrid Vorobjov⁷, Nikita Khmelinskii⁸, Jakub Zavada⁹, Adrian Ciurea¹⁰, Michael Nissen¹¹, Brigitte Michelsen¹², Pawel Mielnik¹³, Anne Gitte Loft¹⁴, Ziga Rotar¹⁵, Katja Perdan Pirkmajer¹⁶, Gary Macfarlane¹⁷, Gareth T. Jones¹⁷, Dan Nordstrom¹⁸, Anna-Mari Hokkanen¹⁹, Irene van der Horst-Bruinsma²⁰, Johan Karlsson Wallman²¹, Bjorn Gudbjornsson²², olafur Palsson²³, Merete Hetland¹ and Lykke Ørnbjerg¹, ¹Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark, ²Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark, ³Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet; University of Copenhagen, Copenhagen, Denmark, ⁴Hospital Universitario Gregorio Marañón, Madrid, Spain, ⁵Spanish Society of Rheumatology, Madrid, Spain, ⁶Department of Rheumatology, East-Tallinn Central Hospital, Tallinn, Estonia, ⁷National Institute for Health Development, Tallinn, Estonia, ⁸Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal, ⁹Institute of Rheumatology; Charles University, Prague, Czech Republic, ¹⁰University Hospital Zurich, Zürich, Switzerland, ¹¹Geneva University Hospitals, Geneva, Switzerland, ¹²Rigshospitalet Glostrup; Diakonhjemmet Hospital; Sørlandet Hospital, Copenhagen, Denmark, ¹³Section for Rheumatology, Helse Førde, Førde, Norway, ¹⁴Aarhus University, Horsens, Denmark, ¹⁵University Medical Centre Ljubljana, Ljubljana, Slovenia, ¹⁶University Medical Centre Ljubljana; University of Ljubljana, Ljubljana, Slovenia, ¹⁷Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom, ¹⁸Helsinki University Hospital, Helsinki, Finland, ¹⁹Departments of Medicine and Rheumatology, Helsinki University Hospital, Helsinki, Finland, ²⁰Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands, ²¹Lund University and Skåne University Hospital, Lund, Sweden, ²²Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland, ²³Faculty of Medicine, University of Iceland, Reykjavik, Iceland

Background/Purpose: Axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are part of the spondylarthritis spectrum that can be treated with secukinumab, a fully human IgG1 monoclonal antibody targeting interleukin-17A. Real-word data on long-term secukinumab effectiveness in these two diseases are limited. In separate cohorts of axSpA and PsA patients treated with secukinumab in routine care, we aimed to assess a) 24-, and 48-month retention rates; and b) proportions of patients achieving 24-, and 48-month composite scores of remission and response.

Methods: Patients with axSpA and PsA who initiated secukinumab were included from 13 registriesparticipating in the European Spondyloarthritis (EuroSpA) Research Collaboration Network [1]. Kaplan-Meier plots with log-rank tests and Cox regression analyses were performed to assess 24-, and 48-month secukinumab retention rates overall, and compared by prior b/tsDMARD status (0/1/≥2). Comparisons of remission and response rates according to b/tsDMARDs status, were performed by logistic regression adjusted for age, gender, register, time since diagnosis and disease activity at treatment start (baseline). Missing baseline data were imputed by multivariate imputation by chained equations.

Results: A total of 767 axSpA and 975 PsA patients from 13 and 12 countries, respectively, were included. At baseline, axSpA patients had a median (IQR) age of 47 (38-55) years, were predominantly male (60%), and had high disease activity (median (IQR)Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP 3.6 (2.9-4.2)). PsA patients had a median (IQR) age of 52 (44-59) years, were predominantly female (56%), and had moderate disease activity (median (IQR) Disease Activity index for PSoriatic Arthritis in 28 joints (DAPSA28) 25.1 (16.7-37.3)). The overall 24-/48-month secukinumab retention rates were 61%/51% in axSpA, and 63%/49% in PsA patients, respectively. The 24-/48-month secukinumab retention rates in axSpA were significantly higher in bio-naïve patients than in patients treated with 1 or ≥2 prior b/tsDMARDs (Figure 1). In PsA patients, both 24-/48-month secukinumab retention rates were similar between bio-naïve patients and patients who previously received 1 prior b/tsDMARD, and numerically lower in patients having received ≥2 b/tsDMARDs (Figure 2). In axSpA patients, ASDAS-CRP low disease activity (LDA) and ASDAS-CRP clinically important improvement (CII) crude rates were numerically higher in the bio-naïve group at 24 and 48 months. After confounder adjustment, bio-naïve patients had higher rates of ASDAS-CRP LDA than patients who had previously received one or more b/tsDMARDs (Table 1). Similarly, the crude proportions of PsA patients achieving DAPSA28 LDA or moderate response were numerically (but not statistically significantly) higher in the bio-naïve group (Table 1).

Conclusion: This large real-life study showed that secukinumab retention rates after four years wereapproximately 50% in patients with axSpA and PsA. Bio-naïve patients had higher retention, remission and response rates than patients with prior b/tsDMARD exposure, particularly in axSpA.

References 1 https://eurospa.eu/.








M. Pons: Novartis, 5; S. Georgiadis: Novartis, 5; Z. Faizy Ahmadzay: Novartis, 5; M. Østergaard: AbbVie, 2, 5, 6, Amgen, 5, Boehringer-Ingelheim, 2, 6, Bristol-Myers Squibb(BMS), 2, 5, 6, Celgene, 2, 5, 6, Eli Lilly, 2, 6, Galapagos, 2, 6, Gilead, 2, 6, Hospira, 2, 6, Janssen, 2, 6, MEDAC, 6, Merck, 2, 5, 6, Novartis, 2, 5, 6, Novo Nordisk, 2, 6, Orion, 2, 6, Pfizer, 2, 6, Regeneron, 2, 6, Roche, 2, 6, Sandoz, 2, 6, Sanofi, 2, 6, UCB, 2, 6; B. Glintborg: AbbVie/Abbott, 5, Pfizer, 5, Sandoz, 5; J. Heberg: Novartis, 5; S. Nysom Christiansen: Novartis, 5, 6; S. Horskjær Rasmussen: Novartis, 5; I. Castrejon: Bristol Myers Squibb, 1, 6, Galapagos, 2, GlaxoSmithKline, 1, 6, Lilly, 1, 6, Merck Sharp & Dohme, 6, Pfizer, 1, 2, 6; F. Alonso: None; K. Laas: None; S. Vorobjov: None; N. Khmelinskii: None; J. Zavada: None; A. Ciurea: None; M. Nissen: AbbVie/Abbott, 2, Eli Lilly, 2, 12, Involved in Clinical Trial, Janssen, 2, Novartis, 6, 12, research funding paid to institution, Pfizer, 6, UCB, 2, 12, funding support to attend EULAR 2023, paid to institution; B. Michelsen: Novartis, 5; P. Mielnik: GALAPAGOS, 2; A. Loft: Ucb, 1, 6, 12, Congress participation; Z. Rotar: None; K. Perdan Pirkmajer: None; G. Macfarlane: None; G. Jones: Amgen, 5; D. Nordstrom: AbbVie/Abbott, 2, BMS, 2, Lilly, 2, MSD, 2, Novartis, 2, Pfizer, 2, UCB, 2; A. Hokkanen: MSD, 5; I. van der Horst-Bruinsma: Abbvie, 2, 5, 5, Lilly, 2, MSD, 2, 5, Novartis, 2, Pfizer, 5, UCB, 2, 5, 6; J. Karlsson Wallman: AbbVie, 5, 6, Amgen, 5, 6, Eli Lilly, 5, Novartis, 5, Pfizer, 5; B. Gudbjornsson: Nordic-Pharma, 6, Novartis, 2, 6; o. Palsson: None; M. Hetland: AbbVie/Abbott, 1, 5, Bristol-Myers Squibb(BMS), 5, Danbio, 12, Chari of Danbio registry, Eli Lilly, 5, MEDAC, 6, Novartis, 5, Pfizer, 5, 6, Sandoz, 5, 6; L. Ørnbjerg: Novartis, 5.