FRI0448 REAL-WORLD EXPERIENCE OF SECUKINUMAB FOR PSORIATIC ARTHRITIS
Authors: LOPEZ MARIA MARTIN, Marta Valero, Valentina Emperiale, Carolina Merino Argumánez, Javier Bachiller-Corral, Jose Campos Esteban, Ana Pérez Gómez, Beatriz Joven-Ibáñez
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Secukinumab, an inhibitor of IL-17, is a new option for the treatment of Psoriatic Arthritis (PsA) which has showed efficacy in clinical trials. However, real-world data of its use is still scarce. <h3>Objectives</h3> This study aims to analyze the experience of using secukinumab for PsA in four tertiary hospitals. <h3>Methods</h3> Multicentric observational, longitudinal, retrospective study conducted in 4 tertiary hospitals of the Madrid region. Patients with clinical diagnosis of PsA and having received at least one dose of secukinumab were included. Medical records were reviewed to collect demographic and clinical data (body mass index, BMI, risk factors cardiovascular disease, cancer, HBV/HCV infection), features of PsA (extra-articular involvement, radiological damage), previous therapies, assessment of the disease and response data at 6 months of secukinumab (joint counts, CRP, DAPSA, reasons for discontinuation, adverse events). Descriptive statistic analysis using mean and standard deviation was performed. <h3>Results</h3> 177 patients, of which 115 female (65%) were included. Mean age was 53 y.o.(SD 15) and average duration of the disease was 9 years (SD 7). 169 patients (95%) had peripheral disease (34% joint erosions), 84 (47%) had axial disease (68 with radiological damage), 148 (84%) had psoriasis, 61 (34%) showed dactilitis and 111 (63%) had enthesitis. Average BMI was 28.4 (SD 6), with an obesity rate of 37% (52 pt). Observed comorbidities were hypertension (22 pt, 12%), diabetes mellitus (22 pt, 12%), dyslipidemia (58 pt, 33%), active smoking (55 pt, 31%) and others: 20 patients had HBV infection, 5 had HCV infection and 12% had malignancy. Regarding previous treatments, 90% had received cDMARDs, particularly methotrexate (77%) and 119 (67%) had been exposed to at least one bDMARD (32% to one, 25% to two, 20% to three and 21% to four or more). 69% were on 150 mg dose and 31% on 300 mg dose. At baseline, average tender joint count was 7 (SD 8), swollen joint count was 4 (SD 4), CRP 7 mg/l and DAPSA 26. At 6 months of secukinumab therapy, tender joint count had decreased to 5 (SD 8), swollen joint count 2 (SD 3), CRP 5 mg/l and DAPSA 17. Thirty-eight (47%) of the patients with the data available (80) had DAPSA ≤14 (low activity) and 9 DAPSA ≤4 (remission). In naïve to biologic patients, DAPSA varied from 27 in the baseline visit to 16 at 6 months, and in the other group of patients with biologic experience, DAPSA varied from 24 to 17 at 6 months (if they had been exposed to 3 or more biologics, DAPSA from 18 to 10 at 6 months). Average drug survival time was 20 months (1-34). 79 patients (44.6%) withdrawn therapy, due to primary ineffectiveness (40), secondary ineffectiveness (26), adverse events (9) and other reasons (3). Adverse events do not differ from those reported in clinical trials. <h3>Conclusion</h3> Secukinumab in real-world setting had been indicated in a population of PsA with a high percentage of axial involvement (47%), with an important previous exposure to biologics, and with higher comorbidity than that reported in clinical trials. Response data were favorable, 47% of patients achieved remission or low activity by DAPSA, and similar profile of adverse events to the one reported in the clinical trials was observed. <h3>References</h3> [1] Mease PJ, McInnes IB, Kirkham B, Kavanaugh A, Rahman P, van der Heijde D, et al. for the FUTURE 1 Study Group* Secukinumab Inhibition of Interleukin-17A in Patients with Psoriatic Arthritis. N Engl J Med2015;373:1329-39 <h3>Disclosure of Interests</h3> MARIA MARTIN LOPEZ: None declared, Marta Valero: None declared, Valentina Emperiale: None declared, Carolina Merino Argumánez: None declared, Javier Bachiller-Corral: None declared, Jose Campos Esteban: None declared, Ana Pérez Gómez: None declared, Beatriz Joven-Ibáñez Speakers bureau: Celgene, Novartis, MSD, Pfizer, AbbVie, and Janssen