Ab0918 Retention Rate of Secukinumab in Spondyloarthritis: Insights From a Real-World Study

Background: Secukinumab is a human monoclonal antibody that selectively binds interleukin 17A, inhibiting its interaction with the interleukin 17 receptor and is prescribed for the treatment of psoriatic arthritis (PsA), plaque psoriasis, ankylosing spondylitis, axial spondyloarthritis, and juvenile idiopathic arthritis. Objectives: To retrospectively evaluate the drug retention rate (DRR) of secukinumab in a monocentric cohort of patients affected by spondyloarthritis. Methods: Patients with a diagnosis of spondyloarthritis and treated with secukinumab who were evaluated at our outpatient clinic from January 2017 to February 2023 were included in the study. Demographic, clinical characteristics, and comorbidities were recorded. DRR was evaluated by Kaplan-Meier method as time to drug discontinuation, and baseline factors predicting drug discontinuation were investigated through Cox regression after adjusting for baseline confounders. Results: One-hundred-seventy-eight patients were included in the study, with a median follow-up of 20.5 (IQR 10-39) months. Among these, 64.6% of patients were female, and 9.7% tested positive for HLAB27. 69.7% of patients presented peripheral involvement, 52.2% axial involvement, 40.4% enthesitis, and 52% psoriasis. Comorbidities were observed in 65.2% of patients, with the most common being hypertension (34.8%), cardiovascular diseases (18.5%), hepatic steatosis (22.5%), diabetes (11.8%), hyperlipemia (23%), kidney disease (6.2%), and a personal history of cancer (10.1%). The multivariable analysis identified the number of previous targeted synthetic or biological DMARD (ts/b DMARDs) (HR 1.44, 95% CI 1.01-2.06), hypertension at baseline (HR 2.56, 95% CI 1.08-6.11), and body mass index (BMI) (HR 1.08, 95% CI 1.01-1.17) as independent predictors of drug discontinuation. In contrast, old age at diagnosis was associated with a lower risk of discontinuation (HR 0.96, 95% CI 0.92-0.99) (Table 1). The drug retention rate at 12, 24 and 48 months was 79.4%, 69.3%, 55% respectively (Figure 1, panels A and B). Conclusion: In our cohort, secukinumab revealed a good DRR. An old age at diagnosis seemed to be protective against withdrawal, whereas the number of previous ts/b DMARDs, hypertension at baseline, and BMI were identified as predictors of drug discontinuation. Further studies are needed to confirm our findings. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Elisa Bellis BMS, Mariele Gatto GSK, Astrazeneca, Janssen, GSK, Denise Donzella Janssen, Gloria Crepaldi Janssen, Galapagos, Eli Lilly, BMS, Novartis, Abbvie, Alfasigma, Valeria Data: None declared, Silvia Di Gregorio: None declared, Marinella Gammino: None declared, Valeria Guardo: None declared, Claudia Lomater Abbvie, BMS, Janssen, Eli Lilly, Novartis, Pfizer, Gaetano Liperoti: None declared, Elena Marucco: None declared, Ginevra Pastorin: None declared, Silvia Perrone: None declared, Marta Saracco: None declared, Annamaria Iagnocco Abbvie, Alfasigma, BMS, Celgene, Celltrion, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Sanofy Genzyme, SOBI, Abbvie, Pfizer, Novartis.