AB0548 EFFECTIVENESS OF IXEKIZUMAB IN PATIENTS WITH PSORIATIC ARTHRITIS: RESULTS FROM A REAL-WORLD EUROPEAN SURVEY
Authors: W. Tillett, V. Navarro-Compán, N. Booth, T. Holzkaemper, J. Hill, E. Lubrano, T. Truer
Journal: Annals of the Rheumatic Diseases (2021)

Background: Limited real world (RW) data are available for IL-17A blocker ixekizumab (Ixe), approved for psoriatic arthritis (PsA) in EU Feb 2018. Objectives: Describe RW outcomes for PsA patients (pts) receiving Ixe. Methods: Cross-sectional, observational study of PsA pts treated with Ixe in the 2020 Adelphi PsA Plus Program (FR, DE, ES &amp; UK). Rheumatologists recruited the first 6 consecutive consulting Ixe pts and provided demographics, PsA manifestations, clinical measures (66 swollen joint count (SJC), 68 tender joint count (TJC), psoriasis area and severity index [PASI], body surface area [BSA] affected by psoriasis [PsO]), rheumatologist-recorded pt measures (skin/joint pain &amp; fatigue [0-10 numeric rating scales (NRS)], health assessment questionnaire [HAQ-DI]) &amp; prescribed dose. All outcomes recorded for pts with scores available at Ixe initiation (II) &amp; at last assessment (LA). Results: 124 rheumatologists provided data for 698 Ixe pts, mean age 49 years (19-79), 48% female, mean BMI 27 (18-44), 56% dermatologist co-managed and mean time diagnosed 6 years (0-35). At Ixe initiation, 78% of pts with known BSA had concomitant mod-sev-PsO defined as BSA≥10% (mean 19.8, n=428) and mean PASI 26.3 (n=164). The predominant PsA phenotype was polyarthritic in 49% (n=345), mono/oligoarthritic in 30% (n=208), axial in 12% (n=81) and enthesitic in 8% (n=55). Previous treatment before Ixe included ≥1 conventional synthetic DMARD (csDMARD) for 71% of pts. Of bio-experienced pts (57%), 40% had received ≥2 biologics. Mean Ixe treatment duration (n=698) 39.4 weeks (wks, 0-170), of which 575 (82%) had received &gt;12 wks of Ixe. 71% of pts received label recommended dose (80mg every 4wks). 52% pts received csDMARD in combination with Ixe. In the RW, Ixe improved TJC, SJC, joint pain, BSA, fatigue and HAQ-DI, Table 1. Table 1. Outcomes for pts receiving Ixe &gt;12weeks (n=575) Overall BSA ≥10% at Ixe initiation Mod-sev-PsO physician judgement Predominant mono/oligo arthritis Predominant polyarthritis With csDMARD Without csDMARD BSA, n 356 270 254 98 184 188 168 mean [SD] Ixe initiation (II ) 19.8 [14.8] 24.7 [13.5] 23.1 [13.6] 17.4 [15.0] 20.9 [15.0] 21.8 [15.0] 17.4 [14.2] Last Assessment (LA ) 6.6 [7.5] 9.3 [8.7] 7.9 [7.9] 5.0 [6.0] 7.6 [8.4] 7.3 [7.9] 5.9 [7.1] Mean weeks on Ixe 43 41 41 50 41 41 46 TJC*, n 125 72 86 39 72 56 69 mean [SD, %&lt;5] II 12.2 [10.6, 29] 14.4 [11.3, 18] 12.9 [11.1, 21] 6.4 [8.2, 59] 15.4 [10.8, 12] 13.0 [9.9, 25] 11.5 [11.1, 32] LA 4.1 [6.4, 77] 5.2 [7.7, 71] 3.6 [6.3, 80] 1.1 [1.4, 97] 6.2 [7.7, 64] 3.4 [3.9, 73] 4.6 [7.8, 80] SJC*, n 145 82 102 44 84 60 85 mean [SD, %&lt;5] II 14.8 [13.5, 33] 18.8 [14.4, 22] 16.3 [13.8, 26] 7.2 [8.5, 68] 18.2 [13.6, 12] 14.5 [12.0, 37] 15.1 [14.8, 31] LA 4.8 [8.7, 79] 7.0 [10.7, 66] 5.1 [9.3, 75] 0.9 [1.9, 95] 6.6 [9.0, 68] 3.1 [7.8, 90] 5.9 [9.1, 71] Joint pain (NRS 0-10), n 575 270 349 166 291 294 281 mean [SD] II 6.6 [1.7] 6.7 [1.7] 6.7 [1.7] 6.2 [1.8] 7.0 [1.5] 6.6 [1.7] 6.6 [1.6] LA 2.7 [1.9] 3.0 [2.1] 2.8 [2.0] 2.1 [1.6] 3.0 [2.1] 2.8 [1.9] 2.5 [1.9] Fatigue (NRS 0-10), n 575 270 349 166 291 294 281 mean [SD] II 5.4 [2.5] 5.8 [2.4] 5.7 [2.5] 4.7 [2.5] 5.7 [2.4] 5.7 [2.4] 5.1 [2.5] LA 2.6 [2.1] 2.7 [2.1] 2.7 [2.2] 2.0 [1.9] 2.9 [2.2] 2.7 [2.1] 2.6 [2.1] HAQ DI, n 59 41 42 10 28 31 28 mean [SD, %&lt;0.5] II 1.8 [0.7, 5] 1.9 [0.6, 0] 1.8 [0.7, 2] 1.9 [0.7, 10] 1.8 [0.8, 7] 1.9 [0.6, 3] 1.7 [0.8, 7] LA 0.8 [0.6, 41] 0.8 [0.6, 32] 0.8 [0.7, 45] 0.7 [0.7, 60] 0.7 [0.6, 36] 0.7 [0.5, 32] 0.7 [0.8, 50] *Additional analysis for pts whose fatigue/joint pain rating improved (from ≥4 at Ixe initiation to ≤3 at LA), their mean TJC was 2.7 &amp; SJC 4.3 at LA for fatigue, TJC 1.7 &amp; SJC 2.7 at LA for joint pain. When BSA was not recorded, physician judgement of PsO severity was used. No imputation of missing data. Conclusion: We report RW outcome data amongst pts treated with Ixe including mono/oligo arthritis and a limited sample of enthesitis and dactylitis pts. Our results are consistent with clinical trial populations across disease domains, including an improvement in joint pain. Disclosure of Interests: William Tillett Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc. and UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc. and UCB, Grant/research support from: AbbVie, Celgene, Eli Lilly &amp; company, Janssen and UCB, Victoria Navarro-Compán Speakers bureau: AbbVie, BMS, Janssen, Eli Lilly &amp; Co, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: AbbVie, BMS, Janssen, Eli Lilly &amp; Co, MSD, Novartis, Pfizer, Roche and UCB, Grant/research support from: AbbVie, BMS, Janssen, Eli Lilly &amp; Co, MSD, Novartis, Pfizer, Roche and UCB, Nicola Booth: None declared., Thorsten Holzkaemper Shareholder of: Eli Lilly &amp; Company, Employee of: Eli Lilly &amp; Company, Julie Hill Shareholder of: Eli Lilly &amp; Company, Employee of: Eli Lilly &amp; Company, Ennio Lubrano Speakers bureau: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Consultant of: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Tamas Truer Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company.