OBJECTIVE: There is a lack of real-life studies on IL-17 inhibition in psoriatic arthritis (PsA). We assessed real-life 6-/12-month effectiveness (i.e. retention, remission, low-disease-activity [LDA] and response rates) of the IL-17 inhibitor secukinumab in PsA patients overall, and across 1) number of prior biologic/targeted synthetic Disease-Modifying Anti-Rheumatic Drugs (b/tsDMARDs), 2) years since diagnosis, and 3) European registries.
METHODS: Thirteen quality registries in rheumatology participating in the European Spondyloarthritis Research Collaboration Network provided longitudinal, observational data collected as part of routine care, for secondary use. Data were pooled and analysed with Kaplan-Meier plots, log-rank tests, Cox regression, and multiple linear and logistic regression analyses.
RESULTS: A total of 2,017 PsA patients started treatment with secukinumab between 2015 and 2018. Overall secukinumab retention rates were 86%/76% after 6/12 months. Crude (LUNDEX adjusted) 6-month remission/LDA (LDA including remission) rates for DAPSA28, DAS28-CRP and SDAI were 13%/46% (11%/39%), 36%/55% (30%/46%) and 13%/56% (11%/47%), and 12-month rates 11%/46% (7%/31%), 39%/56% (26%/38%) and 16%/62% (10%/41%), respectively. CDAI remission/LDA rates were similar to the SDAI rates. Six-month ACR20/50/70 responses were 34%/19%/11% (29%/16%/9%); 12-month: 37%/21%/11% (24%/14%/7%). Secukinumab effectiveness was significantly better for b/tsDMARD naïve patients, similar across time since diagnosis (<2/2-4/>4 years) and varied significantly across the European registries.
CONCLUSION: In this large real-world study on secukinumab treatment in PsA, 6- and 12-month effectiveness was comparable to previous observational studies of TNFi. Retention, remission, LDA and response rates were significantly better for b/tsDMARD naïve patients, independent of time since diagnosis and varied significantly across the European countries.