AB0785 DRUG SURVIVAL OF SECUKINUMAB FOR PSORIATIC ARTHRITIS IN A REAL-WORLD SETTING
Authors: Marta Valero, Beatriz Joven-Ibáñez, María Martín, Jose Campos Esteban, Carolina Merino Argumánez, Valentina Emperiale, Ana Pérez Gómez, Javier Bachiller-Corral
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Secukinumab is a newly introduced biologic therapy against IL-17 which has been approved for Psoriatic arthritis and has showed efficacy in clinical trials, but real world data is still lacking. <h3>Objectives</h3> This study aims to analize secukinumab drug survival for psoriatic arthritis in a real world environment. <h3>Methods</h3> Multicentric observational, longitudinal retrospective study conducted at 4 tertiary hospitals in Madrid region. Patients with clinical diagnosis of psoriatic arthritis which had received at least one dose of secukinumab between january 2016 and october 2018 were included. With follow up period till December 31, 2018. Medical records were reviewed to collect data about psoriatic arthritis involvement, comorbidities, previos DMARD and bDMARD therapies and its reasons for discontinuation, duration of secukinumab therapy, reasons for discontinuating secukinumab therapy and adverse events. Statistical analysis was performed including bivariate analisys (considering withdrawal of drug during study period or not) and survival analysis with Kaplan-Meier and Cox regression. <h3>Results</h3> 177 patients that initiated secukinumab therapy in the recruitment period were included. 123 pacients were on 150 mg dose and 54 on 300 mg dose. Average follow up period was 13 months (SD 8,28; range 1-34) in the bivariate analysis, a higher proportion of biologic-naïve patients was found among the group without secukinumab withdrawal during the study (40% vs 23%, p 0.07). No other differences were observed between both groups regarding demographic characteristics nor comorbidities (tobacco exposure, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease or malignancy). Median survival time for secukinumab in the Kaplan-Meier analysis was 21.2 months (IC 95%: 14.3 - 22.2), with an average of 19,9 months. One event was censored due to lost to follow-up. Secukinumab treatment was withdrawn in 79 patients (44.6%). Reasons for discontinuation were lack of effectiveness (37%), either primary (40 patients) or secondary (26 patients), adverse events (9 patients, 0,5%), elective surgery in one patient and latex allergy in other. The only variable associated to higher drug survival in Cox regression analysis was biologic-naïve status. No differences in drug survival were found in all other variables studied (gender, age, secukinumab dosage, illness duration, clinical features, tobacco exposure and rest of comorbidities). <h3>Conclusion</h3> As secukinumab was marketed in 2016, real-word setting studies lack long term data. The mean follow up period in our study was 13 months. Most of withdrawals were to lack of effectiveness. Median survival was 21.2 months, significatively higher in biologic-naïve patients. No other differences were found in all other variables studied. Probably real-world data differ from those of clinical trials. <h3>Disclosure of interests</h3> Marta Valero: None declared, Beatriz Joven-Ibáñez Speakers bureau: Celgene, Novartis, MSD, Pfizer, abbVie, and Janssen, María Martín: None declared, Jose Campos Esteban: None declared, Carolina Merino argumánez: None declared, Valentina Emperiale: None declared, ana Pérez Gómez: None declared, Javier Bachiller-Corral: None declared