FRI0444 EFFICACY AND SAFETY OF SECUKINUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS FOLLOWING INADEQUATE RESPONSE TO SYNTHETIC OR BIOLOGICAL DISEASE MODIFYING ANTIRHEUMATIC DRUGS IN REAL-LIFE SETTINGS
Authors: Kalliopi Klavdianou, Argyro Lazarini, Dimitrios Tseronis, Christina Tsalapaki, Panagiota Rapsomaniki, Katerina Antonatou, Konstantinos Thomas, Dimitrios Boumpas, Dimitrios Vassilopoulos, KATSIMPRI PELAGIA
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The data regarding the efficacy and safety of Secukinumab (SEC) in patients with psoriatic arthritis (PsA) in daily clinical practice are scarce. <h3>Objectives</h3> To assess the <b>safety and efficacy of</b> SEC in patients with PsA in real life settings. <h3>Methods</h3> All PsA patients treated with SEC in the Rheumatology Units of 2 referral University Hospitals were prospectively included (from 3/2016-12/2018). Patients' characteristics, treatments and indices of disease activity (DAPSA, DAS28-CRP, BASDAI) and function (HAQ, BASFI) as well as the extent of skin disease (BSA) were recorded at baseline and during therapy. <h3>Results</h3> 79 patients treated with SEC were included; 75% were females (n=59) with a mean age of 54±13.4 years, a median disease duration of 7.8 years and a median SEC treatment duration of 10 months (IQR 13). At baseline, 42% had axial involvement, 25% enthesitis and 13% dactylitis. The majority of patients had previously failed anti-TNFs (91%, n=72; n=1: 32%, n=2: 43% or n≥3: 25%), anti-IL12/23 (37%), both biologic agents (34%) or apremilast (5%). SEC was administered in combination with csDMARDs in 55% and corticosteroids in 40% of patients, respectively. At the end of the <b>follow-up</b> period (median: 15 months), patients' disease activity (median DAPSA: 29 → 18.5, p&lt;0.001, DAS28-CRP: 4.6 → 3.7, p=0.05, BASDAI: 5.5 → 3.2, p=0.15), function (median HAQ: 1 → 0.38, p=0.07, BASFI: 7 → 3.2, p=0.14) and skin psoriasis (median βSA: 2 → 0%, p=0.005) improved. Drug survival at the last follow-up visit was 63% (n=50). Reasons for SEC discontinuation were inadequate response (25%, n=20), serious adverse events (7%, n=5) or other reasons (5%, n=4). During follow-up there were 12 adverse events (1.2/100 patient-years); among them 5 were serious (0.5/100 patient-years). The rate of serious infections was 0.1/100 patient-years. Two fungal infections (one oral-genital and one inguinal that improved with local therapy) and three cases of cancer were also recorded (two colon cancers/one fatal and one endometrial cancer). <h3>Conclusion</h3> In a large, real life, cohort of patients with PsA, resistant to different biologics (anti-TNFs and/or anti-IL12/23), SEC displayed a high retention rate (63% after a median follow-up of 15 months) without significant side effects. These data emphasize the role of SEC as a viable therapeutic option even in patients with difficult to treat, multi-resistant PsA in daily clinical practice. <h3>Acknowledgement</h3> This work was supported by research grants from the Special Account for Research Grants (S.A.R.G.), National and Kapodistrian University of Athens, Athens, Greece <h3>Disclosure of Interests</h3> None declared