Access, Effectiveness, Safety, and Survival of Secukinumab in Patients With Axial Spondyloarthritis and Axial Psoriatic Arthritis: A Real-World Study in Argentina

Objective To describe the access, effectiveness, survival, and adverse events (AEs) of secukinumab (SEC) in patients with axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA). Methods In a multicenter, observational, retrospective cohort study, patients ≥ 18 years with axSpA or axPsA who had received ≥ 1 dose of SEC were included. The number of days between the request for the drug and the first application was calculated. Effectiveness was defined as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 4 at 6 months. Drug survival was analyzed using Kaplan-Meier curves and Cox regression analysis. Results One hundred seventeen patients were included: 72 (61.5%) with axPsA and 45 (38.5%) with axSpA. Those having public health insurance presented a longer delay in receiving SEC (median 90 days [IQR 60-150]) vs those using the social security system (P = 0.01) and those with private health coverage (P = 0.009). Effectiveness of SEC after 6 months was achieved in 72/117 patients (61.5%): 44/72 patients with axial PsA (61.5%) and 28/45 patients with axSpA (62.2%; P = 0.91). The median SEC survival was 48 months (95% CI 32-63). The only factor associated with reduced survival was SEC as third-line treatment or higher (hazard ratio 3.43, 95% CI 1.11-11.10; P = 0.04). The incidence of AEs was 7.9 events/100 patients/year (95% CI 5-12). Conclusion The delay in receiving SEC was longer in patients with public health insurance. Patients using SEC as third-line or higher therapy had 3.4 times less survival. AEs were mild and no AEs of interest were observed.