AB0745 REAL-LIFE EXPERIENCE FOR SECUKINUMAB IN PSORIATIC ARTHRITIS FROM HURBio-PsA DATABASE
Authors: E. C. Bolek, E. Bilgin, G. K. Yardimci, B. Farisoğullari, E. Duran, B. Armagan, L. Kiliç, Ş. A. Bilgen, A. İ. Ertenli, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Biologic disease modifying anti-rheumatic drugs (bDMARD) are revolutionary treatment options for management of inflammatory arthritis. Secukinumab (SEC), anti-interleukin-17A monoclonal antibody, is a new alternative choice to anti-TNFs and IL-12/23 blocking agents in the therapy of psoriatic arthritis (PsA). In Turkey, government health insurance system covers secukinumab for at bDMARD-refractory PsA patients. Objectives: In this study, analyzing of parameters that related with effectiveness and drug survival rates for patients using SEC from Hacettepe University Rheumatology Biologic Registry (HURBio-PsA) were aimed. Methods: HURBio-PsA is a monocentric biologic database including 470 PsA by December 2020. Sixty-two PsA patients that recorded with prescribed SEC in the database were evaluated. Sixteen patients have no control clinical-visit were excluded. Descriptives and demographics were recorded and Kaplan-Meier analysis was used to estimate SEC drug-retention rates. Results: Fourty-two (26.1% male) PsA patients treated with SEC) were included. Characteristics of the patients at the baseline and the last visit were shown in Table. Last visit scores of DKYI, Patient VAS Global, VAS Fatigue, VAS Pain and BASDAI showed statistically significant improvements in comparison with first visit values. Median duration of SEC usage was 5.4 (Min-Max: 0.18-18.6) months. SEC drug-retention rate at 12 months were 69% and 54.4% for two PsA groups that were used previously 1 and ≥2 bDMARDs, respectively (p=0.743, Figure). Conclusion: In this real-world study derived from single center experience; there is no statistically significant difference for drug survival rates of SEC therapy in the patient groups used 1 and ≥2 bDMARDs. Effectiveness and drug-survival shoul be obviously verified by data derived from multicenter large cohorts. Table 1. Baseline characteristics of PsA patients with treated with Secukiumab All Patients (n=62) 1 bDMARD exposed (n=18) ≥ 2 bDMARD exposed (n=44) p Gender, Female, n(%) 47 (75.8) 12 (66.7) 35 (79.5) 0.334 Age at the disease diagn osis, years, mean±SD 42 ± 11.65 35 ± 5.65 38.6 ± 10.7 0.721 Age at SEC starting, years, mean±SD 48.2 ± 10.8 43 ± 2.8 49.5 ± 11.3 0.182 Median duration of SEC treatment, median (min-max) 6.3 (0.9-18.6) 3.3 (3.2-3.3) 9 (4-20) 0.519 HLA-B27 positivity, n(%) 3/24 (12.5) 1 (14.3) 2 (11.8) 1 BMI, kg/m 2 , mean±SD 28.9 ± 5.9 32.6 ± 3.7 28.4 ± 6.0 0.546 Ever smokinig history, n(%) 40/61 (65.6) 13 (72.2) 27 (62.8) 0.6 Uveitis, n(%) 3 (4.8) 0 (0) 3 (6.8) 0.55 PsA/Psp family history, n(%) 22 (35.5) 2 (11.1) 20 (45.5) 0.01 Table 2. Activity parameters of PsA patients have a least clinical visit 1 bDMARD exposed (n=) ≥ 2 bDMARD exposed (n=) First Visit Last Visit p First Visit Last Visit p DAS28, Median (IQR) 2.8(1.5) 2.8 (1.8) 0.155 3.9 (1.7) 3.5 (1.4) 0.414 HAQ, Median (IQR) 0.3 (0.7) 0.05 (0.61) 0.065 0.7 (0.9) 0.5 (0.85) 0.500 DKYI, Median (IQR) 4 (4.5) 0 (3) 0.049 11 (15) 5 (9) 0.003 ESR, Median (IQR) 19 (23.2) 17.5 (18.7) 0.398 28 (38) 35 (27.9) 0.082 C-RP, Median (IQR) 0.49 (0.64) 0.41 (0.75) 0.724 0.73 (1.8) 1 (2) 0.564 BASDAI, Median (IQR) 61 (61) 27.5 (48) 0.005 58 (31) 46 (39) 0.038 BASFI, Median (IQR) 38 (50) 9.4 (54.5) 0.035 43 (53) 36 (47) 0.480 Tender Joint Count, Median (IQR) 0 (0.5) 0 (0.5) 0.180 1 (4) 0 (9) 0.720 Swollen Joint Count, Median (IQR) 0 (1.2) 0 (0) 0.357 0 (2) 0 (0) 0.635 VAS Global Patient, Median (IQR) 80 (55) 25 (45) 0.006 60 (20) 50 (50) 0.032 VAS Fatigue, Median (IQR) 65 (62.5) 40 (62.5) 0.027 60 (40) 50 (40) 0.110 VAS Pain, Median (IQR) 80 (57.5) 40 (72.5) 0.022 70 (30) 60 (50) 0.170 Figure. Drug Retention Rate for Secukinumab Disclosure of Interests: Ertugrul Cagri Bolek: None declared, Emre Bilgin: None declared, Gözde Kübra Yardimci: None declared, Bayram Farisoğullari: None declared, Emine Duran: None declared, Berkan Armagan: None declared, Levent Kiliç: None declared, Şule Apraş Bilgen: None declared, Ali İhsan Ertenli: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB