SAT0299 Real world secukinumab study in as and psa – comorbidities and extraarticular manifestations: incidence and status throughout non-interventional aquila study in germany
Authors: U. Kiltz, P. Kästner, H. Krauel, I. Schwarze, J. Brandt-Jürgens, M. Maier-Peuschel, C. Legeler, J. Veit, H.-P. Tony
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS) may suffer from extraarticular manifestations (EAM) (uveitis, psoriasis) and have higher rates of comorbidities like cardiovascular diseases (CVD) or depression than the normal population. Comorbidities should be kept in mind when managing pts with PsA and AS, as they can contribute to increased mortality and influence disease activity<sup>1</sup>. <h3>Objectives</h3> The aim of this interim analysis is to evaluate the incidence of selected EAM and comorbidities at baseline and the impact of secukinumab on the status of these attributes compared to baseline. <h3>Methods</h3> The presence and severity of uveitis and psoriasis (assessed by PASI) as well as diagnosis of coronary heart disease (CHD), stroke, heart insufficiency, and depression (assessed by Becks Depression Inventory (BDI-II) were documented according to clinical routine at baseline and at week 4, 16, 24 and 52 after initiation of secukinumab. At baseline 486 patients were included and observed up to 52 weeks, at the time of analysis not all patients have already reached the end of the study, therefore the results are presented as observed. <h3>Results</h3> As expected, current plaque psoriasis was very frequent in PsA pts (63.3%), but also present in AS pts (11.5%) at baseline. For PsA pts, median PASI improved from 5.0 at baseline to 0.0 at wk 52. Half of pts with available PASI achieved clear skin at wk 52 (Tab 1). Uveitis was more frequent in AS pts than in PsA pts (6.2% vs 0.9%). Only 1 AS pt and 2 PsA pts experienced new onset of uveitis. CVD were more frequent in PsA than in AS patients at baseline: CHD (PsA 8.9%, AS 3.5%), heart failure (PsA 3.3%, AS 0.7%) and stroke (PsA 2.4%, AS 0.0%). During 52 wks study duration none comorbidity worsened with secukinumab treatment. Two patients with PsA were newly diagnosed with CHD and heart insufficiency throughout wk 52. No new stroke occurred. Depression was common in both populations (PsA 15.4%, AS 12.2%) at baseline. Up to wk 52 median BDI-II improved from 12.0 to 6.0 (AS pts) and from 9.0 to 6.0 (PsA pts [Tab 1]). <h3>Conclusions</h3> Incidence of CVD and depression in PsA and AS pts is generally comparable to the published literature<sup>2,3</sup>. However, in contrast to other studies<sup>4</sup>, previous uveitis was less frequently reported in SpA pts selected for treatment with a IL-17 inhibitor, particularly in the AS group. Cardiovascular comorbidities remained overall stable under secukinumab up to wk 52. Plaque psoriasis and depressive mood improved with Secukinumab treatment. <h3>References</h3> [1] Tournadre A, et al. Ther Adv Musculoskel Dis2016;8(5):180–91. [2] Wibetoe G, et al. Arthritis Res Ther2017;19(1):153. [3] Husni ME, et al. Semin Arthritis Rheum2017;47(3):351–60. [4] Rosenbaum JT. Clin Rheumatol2015;34:999–1002. <h3>Acknowledgements</h3> C. Blank, PhD (Winicker-Norimed) for medical writing support, which was funded by Novartis Pharma GmbH, Germany <h3>Disclosure of Interest</h3> U. Kiltz Grant/research support from: AbbVie, Chugai, Grünenthal, MSD, Novartis, Pfizer, Roche, UCB, Consultant for: AbbVie, Chugai, MSD, Novartis, Pfizer, Roche, UCB, P. Kästner Consultant for: Chugai, Novartis, H. Krauel: None declared, I. Schwarze: None declared, J. Brandt-Jürgens: None declared, M. Maier-Peuschel Employee of: Novartis Pharma GmbH, C. Legeler Employee of: Novartis Pharma GmbH, J. Veit Employee of: Novartis Pharma GmbH, H.-P. Tony Consultant for: AbbVie, Astra-Zeneca, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi