THU0390 THE INFLUENCE OF OBESITY ON RETENTION AND TREATMENT RESPONSE OF SECUKINUMAB IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: REAL LIFE DATA FROM THE TURKBIO REGISTRY
Authors: A. Karakas, S. Gulle, T. Yüce İnel, S. Uslu, A. Köken Avşar, S. B. Kocaer, Y. Erez, G. Can, M. Birlik, A. Yazici, A. Tufan, E. Dalkiliç, S. S. Koca, N. Akkoc, S. Akar, İ. Sari, F. Onen
Journal: Annals of the Rheumatic Diseases (2020)

Background: Axial spondyloarthritis (axSpA) is a chronic, inflammatory disease that primarily affects the axial skeleton. Secukinumab is a human monoclonal antibody that binds to the protein interleukin (IL)-17A. Although some studies showed that obesity had a negative effect on the efficacy of tumor necrosis factor alpha inhibitor (TNFα -i) treatment in AS patients (1), no data is available for secukinumab. Objectives: To evaluate the effect of obesity on the treatment response and drug survival of secukinumab in patients with axSpA. Methods: We performed an observational cohort study based on the TURKBIO between 2018-2020. A total of 185 patients were included in the study. The patients were divided into three groups as obese (BMI≥30 kg/m 2 ), overweight (BMI:25-30 kg/m 2 ), and normal (BMI&lt;25 kg/m 2 ). Disease activity was evaluated at baseline and 3, 6 and 12 months of secukinumab therapy. Clinical response was evaluated as achievement of BASDAI50, ASAS20/40, and ASDAS-Clinical and improvement (CII and MI) rates. Results: 185 axSpA patients were identified in the registry; 135 (72%) had available BMI data. Thirty nine (28.8%) patients were obese. The mean age of obese patients was higher (p=0.002). The frequency of HLA-B27 and male gender was lower in obese group (p=0.012 and p=0.013, respectively). There was no significant difference between groups in terms of clinical response parameters at 3, 6 and 12 months (Table 1). Drug retention rates were higher in biologic naive patients(p=0.007) (Figure 1). Table 1 (BMI &lt;25) (n=33 ) (BMI 25-30)(n=63 ) (BMI ≥ 30)(n=39 ) P All patients (n=185 ) Age (years ) 40.2±11.3 45.7±11.7 50.0±10.6 0.002 * 45.2±11 Male Gender n (% ) 25 (75.8) 34 (54.0) 16 (41.1) 0.012 ** 104 (56.2) HLA-B27 (+) n (% ) 14 (73.6) 37 (84.0) 11 (44.0) 0.013 ** 76 (64.3) Prior Naive/1/≥2 bDMARD n (% ) 12 (36.3)/9 (27.3)/12 (36.3) 17 (26.9)/13 (20.6)/33 (52.4) 10 (25.6)/14 (35.8)/27 (69.2) 0.302 56 (30.3)/ 49 (26,5)/ 80 (43,2) ASAS20 response¶ 13 (61.9)/11 (57.9)/4 (57.1) 19 (48.7)/16 (59.3)/8 (42.1) 11 (40.7)/7 (29.1)/3 (50.0) 0.345/0.073/0.886 59 (518)/47 (49.5)/20 (42.6) ASAS40 response¶ 9 (42.9)/7 (36.8)/3 (42.9) 15 (39.5)/10 (37)/1 (5.3) 6 (24)/5 (20,8)/3 (50.0) 0.334/0.386/0.012 40 (35.0)/29 (30.5)/11 (23.4) BASDAI50 response ¶ 10 (47.6)/9 (47.4)/4 (57.1) 15 (39.5)/11 (40.5)/3 (15.8) 9 (34.6)/5 (21.7)/3 (50.0) 0.634/0.192/0.077 48 (42.1)/37 (38.9)/16 (34.0) ASDAS-CII ¶ 3 (14.3)/5 (26.3)/1 (14.3) 6 (17.6)/8 (30.8)/5 (27.8) 6 (23.1)/5 (21.7)/2 (33.3) 0.237/0.162/0.531 23 (21.4)/22 (23.6)/11 (23.9) ASDAS-MI ¶ 5 (23.8)/3 (15.8)/0 (0) 8 (23.5)/6 (23.1)/2 (11.1 1 (3.8)/1 (4.3)/1 (16.7) 0.237/0.162/0.531 18 (16.8)/18 (19.3)/8 (17.4) §; Mean±SD. ¶; at 3/6/12 Months, n (%),*One-way ANOVA test, ** Pearson Chi-Sqaure Test Figure 1 Conclusion: This study demonstrated that obesity had no impact on the efficacy and retention of secukinumab treatment in patients diagnosed with axSpA. The drug survival was found to be higher among biologic-naive axSpA patients compared to biologic-experienced. References: [1]Ottaviani S.et al. ‘’Body mass index influences the response to infliximab in ankylosing spondylitis’’,Arthritis Res Ther 2012; 14: R11 Disclosure of Interests: None declared