1417: Do Long-term Patient-reported Outcomes Improve Similarly in Psoriatic Arthritis and Axial Spondyloarthritis Patients Treated with Secukinumab? Results from the EuroSpA Collaboration

Marion Pons¹, Simon Horskjær Rasmussen¹, Sara Nysom Christiansen¹, Brigitte Michelsen², Bente Glintborg¹, Bjorn Gudbjornsson³, Gerdur Maria Grondal⁴, Jiri Vencovsky⁵, Anne Gitte Loft⁶, Ziga Rotar⁷, Katja Perdan Pirkmajer⁸, Michael Nissen⁹, Burkhard Moeller¹⁰, Gary Macfarlane¹¹, Gareth T. Jones¹¹, Florenzo Iannone¹², Roberto F. Caporali¹³, Karin Laas¹⁴, Sigrid Vorobjov¹⁵, Daniela Di Giuseppe¹⁶, Belkis Nihan Coskun¹⁷, Burcu Yagız¹⁷, Sella Provan¹⁸, Karen Fagerli¹⁸, Isabel Castrejon¹⁹, Lucia Otero-Valera²⁰, Marleen van de Sande²¹, Irene van der Horst-Bruinsma²², Dan Nordstrom²³, Laura Kuusalo²⁴, Elsa Vieira-Sousa²⁵, Miguel Bernardes²⁶, Tor Olofsson²⁷, Jana Baranová²⁸, Merete Hetland¹, Mikkel Østergaard²⁹ and Lykke Ørnbjerg¹, ¹Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark, ²Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway, ³Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland, ⁴Department for Rheumatology, Landspitali University Hospital, Reykjavik, Iceland, ⁵Institute of Rheumatology, Prague, Czech Republic, Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, ⁶Aarhus University, Horsens, Denmark, ⁷University Medical Centre Ljubljana, Ljubljana, Slovenia, ⁸University Medical Centre Ljubljana; University of Ljubljana, Ljubljana, Slovenia, ⁹Geneva University Hospitals, Geneva, Switzerland, ¹⁰Inselspital - University Hospital Bern, Bern, Switzerland, ¹¹Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom, ¹²Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy, ¹³Department of Clinical Sciences and Community Health, University of Milan, and Department of Rheumatology and Medical Sciences, ASST Gaetano Pini-CTO, Milano, Italy, ¹⁴Department of Rheumatology, East-Tallinn Central Hospital, Tallinn, Estonia, ¹⁵National Institute for Health Development, Tallinn, Estonia, ¹⁶Karolinska Institutet, Stockholm, Sweden, ¹⁷Department of Rheumatology, Bursa Uludag University, Bursa, Turkey, ¹⁸Diakonhjemmet Hospital, Oslo, Norway, ¹⁹Hospital Universitario Gregorio Marañón, Madrid, Spain, ²⁰Spanish Society of Rheumatology, Madrid, Spain, ²¹Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Infection & Immunity Institute; Amsterdam Rheumatology & Immunology Center (ARC), Academic Medical Center, Amsterdam, Netherlands, ²²Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands, ²³Helsinki University Hospital, Helsinki, Finland, ²⁴Centre for Rheumatology and Clinical Immunology, University of Turku and Turku University Hospital, Turku, Finland, ²⁵Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal, ²⁶Rheumatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal, ²⁷Lund University and Skåne University Hospital, Lund, Sweden, ²⁸Institute of Biostatistics and Analyses, Brno, Czech Republic, ²⁹Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet; University of Copenhagen, Copenhagen, Denmark

Background/Purpose: Patient reported outcomes (PROs) are important in the treatment evaluation of patients with spondyloarthritis, including axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). For secukinumab, limited real world data on PROs is available – and no comparison between axSpA and PsA patients has been performed. In European patients with axSpA and PsA who initiated secukinumab, we aimed to determine: 1) the proportion of patients achieving 6-, 12- and 24-month pain, fatigue, patient global assessment (PGA) and health assessment questionnaire (HAQ) remission, and 2) the 24-month secukinumab retention rate.

Methods: The study was conducted within the European Spondyloarthritis Research Collaboration Network (EuroSpA)(1). From 16 European registries, patients with axSpA or PsA who initiated secukinumab between 2015 and 2021 were included. Based on the ASAS working group definition of partial remission in axSpA(2), we applied the following definitions of PRO remission: pain≤20, PGA≤20, fatigue≤20 (all on visual analogue scales 0-100 mm) and HAQ≤0.5 for both axSpA and PsA patients, to make comparisons feasible.PRO remission rates were calculated as crude and adjusted for secukinumab adherence (LUNDEX). Comparisons of remission rates were performed with univariable and multivariable (baseline covariates: age, gender, registry, and number of previous b/tsDMARDs)logistic regression analyses. Kaplan-Meier with log-rank test and Cox regression analyses were performed to assess and compare the 24-month secukinumab retention rate between axSpA and PsA patients.

Results: We included 3062 axSpA patients and 3217 PsA patients initiating secukinumab in routine care. At secukinumab treatment start (baseline), axSpA patients had a mean (SD) age of 46.8 (12.0) years, with 52.7% being male. PsA patients had a mean age (SD) of 51.9 (11.9) years and were predominantly female (56.9%). No clinically relevant differences in disease duration, physician global assessment (PhGA), number of previous b/tsDMARDs or PROs values were found at baseline (Table 1). The reductions in pain, fatigue, and PGA values from baseline to 24-month follow-up were greater in axSpA patients compared to PsA patients. While crude PRO remission rates (pain, fatigue, PGA and HAQ) were higher for axSpA than for PsA patients at all timepoints, LUNDEX-adjusted remission rates were similar (Table 2). After correction for multiple confounders no difference was found between the groups, except for a higher remission rate for fatigue in PsA at 24 months (OR= 1.8 [95% CI 1.1-3.0]) (Table 2). The 24-month retention rates were similar in axSpA and PsA (61.2% vs. 62.8%, HR= 0.92 [95% CI 0.84-1.02], p=0.14 in fully adjusted analyses) (Figure 1).

Conclusion: Our study supports the real-world effectiveness of secukinumab in both axSpA and PsA, as measured by PROs, and suggests that PROs (including pain, PGA and HAQ) and 24-month retention rate after secukinumab initiation are similar in axSpA and PsA patients. Further analyses, aiming to evaluate long-term effectiveness of axSpA and PsA are needed.

References
1. Anon. https://eurospa.eu/.
2. Anderson JJ et al. Arthritis and Rheumatism 2001;44:1876–1886.








M. Pons: Novartis, 5; S. Horskjær Rasmussen: Novartis, 5; S. Nysom Christiansen: Novartis, 5, 6; B. Michelsen: Novartis, 5; B. Glintborg: AbbVie/Abbott, 5, Pfizer, 5, Sandoz, 5; B. Gudbjornsson: Nordic-Pharma, 6, Novartis, 2, 6; G. Grondal: None; J. Vencovsky: Argenx, 2, Eli Lilly, 6, Galapagos, 2, Horizon, 2, Merck, 2; A. Loft: Ucb, 1, 6, 12, Congress participation; Z. Rotar: None; K. Perdan Pirkmajer: 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. Moeller: None; G. Macfarlane: None; G. Jones: Amgen, 5; F. Iannone: Abbvie, 2, 5, BMS, 2, 5, Janssen, 2, 5, Lilly, 2, 5, MSD, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, Roche, 2, 5, UCB, 2, 5; R. Caporali: AbbVie, 2, 6, Amgen, 2, 6, BMS, 2, 6, Celltrion, 2, 6, Fresenius Kabi, 2, Galapagos, 2, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 2, Sandoz, 2, 6, UCB, 2, 6; K. Laas: None; S. Vorobjov: None; D. Di Giuseppe: None; B. Nihan Coskun: None; B. Yagız: None; S. Provan: None; K. Fagerli: None; I. Castrejon: Bristol Myers Squibb, 1, 6, Galapagos, 2, GlaxoSmithKline, 1, 6, Lilly, 1, 6, Merck Sharp & Dohme, 6, Pfizer, 1, 2, 6; L. Otero-Valera: None; M. van de Sande: AbbVie, 2, Eli Lilly, 5, Janssen, 6, Novartis, 2, 5, 6, UCB Pharma, 2, 5, 6; I. van der Horst-Bruinsma: Abbvie, 2, 5, 5, Lilly, 2, MSD, 2, 5, Novartis, 2, Pfizer, 5, UCB, 2, 5, 6; D. Nordstrom: AbbVie/Abbott, 2, BMS, 2, Lilly, 2, MSD, 2, Novartis, 2, Pfizer, 2, UCB, 2; L. Kuusalo: None; E. Vieira-Sousa: Abbvie, 6, Celgene, 6, MSD, 5, 6, Novartis, 6, Pfizer, 5, UCB, 5, 6; M. Bernardes: None; T. Olofsson: Merck Sharp & Dohme, 2, UCB Pharma, 2; J. Baranová: 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; 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; L. Ørnbjerg: Novartis, 5.