Ab0212 Secukinumab in Patients With Spondylarthritis and a History of Malignancy: Experience From a Large Monocentric Cohort

Background: Secukinumab is a monoclonal antibody directed against interleukin-17 approved for the treatment of psoriasis and spondylarthritis. The favorable oncological profile of secukinumab in patients with a history of malignancy has been shown in patients with psoriasis. However, systematic data to this regard have not been published yet for patients with spondylarthritis. Objectives: To investigate the oncological safety of secukinumab in a large monocentric cohort of patients with spondylarthritis and a history of cancer. Methods: We retrospectively identified from our cohort patients with spondylarthritis treated with secukinumab and with a history of malignancy. Patients with non-melanoma skin cancer were excluded. Full baseline (i.e., at secukinumab start) demographic, rheumatic disease and treatment features were collected. Data about the interval between cancer diagnosis and secukinumab start, the type of neoplasm and its management, and oncological status at secukinumab start and at the last available follow-up visit were recorded. Variations of Ankylosing Spondylitis Disease Activity Score (ASDAS) between treatment start and the last available visit were also recorded to assess the clinical efficacy of secukinumab. Results: We identified 22 patients with spondylarthritis and a history of malignancy who had been treated with secukinumab. Their demographic and rheumatologic features are shown in Table 1. The most frequent oncological diagnosis was breast cancer (n=7, 32%). One patient was diagnosed with two different neoplasms (i.e., renal and thyroid cancer) before the start of secukinumab. Surgical operation was the most common treatment received by these patients (n=19; 86%), followed by chemotherapy (n=7, 32%) and radiotherapy (n=7 l – 32%). Median interval between cancer diagnosis and secukinumab start was 24 (IQR 3-101) months. Three patients had active cancer at the initiation of secukinumab (two were receiving chemotherapy and one was undergoing radiotherapy), while the others were in oncological remission. Secukinumab was administered at the dosage of 150 and 300 mg monthly in 14 and 8 patients, respectively. Over a median follow-up of 30 (IQR 14-64) months no case of cancer recurrence or progression was recorded. No serious adverse reactions (including infections requiring hospital admission) were recorded. Median ASDAS value decreased from a baseline value of 2.5 (1.9 – 2.7; i.e., high disease activity) to 1.2 (1.1 – 1.2; i.e., remission) at the last available visit on secukinumab (p-value calculated with Mann-Whitney test <0.001). Conclusion: In the largest cohort reported to date to this regard, secukinumab was not associated with oncological recurrence or progression in patients with spondylarthritis with a history of malignancy. Secukinumab may therefore represent a safe option in this clinical scenario. Table 1. Demographic and rheumatologic features of the study population at secukinumab start. Categorial and continuous variable are expressed as absolute number (percentage) and median (interquartile range – IQR), respectively. ASDAS, Ankylosing Spondylitis Disease Activity Score; csDMARDs, conventional synthetic disease modifying anti-rheumatic drugs; TNFi, Tumor Necrosis Factor inhibitors. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Nicola Farina: None declared, Alessandro Tomelleri Novartis, nicola boffini Novartis, Adriana Cariddi: None declared, Stefania Laura Calvisi: None declared, Elena Baldissera Novartis, Marco Matucci-Cerinic Novartis, Lorenzo Dagna Novartis.