Real-world experience with secukinumab in the entire axial spondyloarthritis spectrum

Francisca Sivera; Victoria Núñez-Monje; Cristina Campos-Fernández; Isabel Balaguer-Trull; Montserrat Robustillo-Villarino; Marta Aguilar-Zamora; Marta Garijo-Bufort; Juan Miguel López-Gómez; Carolina Peña-González; Isabel de la Morena; Diego Bedoya-Sanchís; Liliya Yankova-Komsalova; Arantxa Conesa-Mateos; Anna Martínez-Cristóbal; Francisco Javier Navarro-Blasco; José Miguel Senabre-Gallego; Juan José Alegre-Sancho

doi:10.3389/fmed.2023.1156557

Real-world experience with secukinumab in the entire axial spondyloarthritis spectrum

Front Med (Lausanne). 2023 May 11:10:1156557. doi: 10.3389/fmed.2023.1156557. eCollection 2023.

Authors

Francisca Sivera^{1

2}, Victoria Núñez-Monje³, Cristina Campos-Fernández⁴, Isabel Balaguer-Trull⁴, Montserrat Robustillo-Villarino⁵, Marta Aguilar-Zamora⁶, Marta Garijo-Bufort⁶, Juan Miguel López-Gómez¹, Carolina Peña-González⁷, Isabel de la Morena⁸, Diego Bedoya-Sanchís⁸, Liliya Yankova-Komsalova⁹, Arantxa Conesa-Mateos¹⁰, Anna Martínez-Cristóbal¹¹, Francisco Javier Navarro-Blasco¹², José Miguel Senabre-Gallego¹³, Juan José Alegre-Sancho³

Affiliations

¹ Rheumatology Department, Hospital General Universitario de Elda, Alicante, Spain.
² Departament of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain.
³ Rheumatology Department, Hospital Universitario Dr Peset, Valencia, Spain.
⁴ Rheumatology Department, Hospital General Universitario, Valencia, Spain.
⁵ Reumatology Unit, Internal Medicine Department, Hospital Universitario de la Plana, Villarreal, Spain.
⁶ Rheumatology Department, Hospital de Sagunto, Sagunto, Spain.
⁷ Rheumatology Department, Hospital Francesc de Borja, Gandía, Spain.
⁸ Rheumatology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain.
⁹ Rheumatology Department, Hospital Marina Salud, Denia, Alicante, Spain.
¹⁰ Rheumatology Department, Hospital General Universitari de Castelló, Castellón, Spain.
¹¹ Rheumatology Department, Hospital Universitario de La Ribera, Alzira, Spain.
¹² Rheumatology Department, Hospital Universitario de Elche, Elche, Alicante, Spain.
¹³ Rheumatology Department, Hospital Marina Baixa, La Vila Joiosa, Spain.

Abstract

Background: Secukinumab is a biologic disease-modifying antirheumatic drug (bDMARD) that has demonstrated efficacy in the treatment of axial spondyloarthritis (axSpA, i.e., ankylosing spondylitis and non-radiographic axSpA) across various clinical trials. However, data of secukinumab in clinical practice is still limited. Here, we aimed to provide real-world data on secukinumab use, effectiveness, and persistence in axSpA.

Patients and methods: Retrospective, multicenter study of patients with a diagnosis of axSpA treated with secukinumab at 12 centers up to June 2021 in the Valencian Community (Spain). Information was gathered on BASDAI measurement, pain, patient and physician global assessment (ptGA, phGA) using a 100-mm visual analog scale (VAS), persistence and other secondary variables by treatment line (first, second, and ≥ third) for up to 24 months.

Results: 221 patients were included (69% men; mean age [standard deviation, SD]: 46.7 [12.1] years old). Secukinumab was used as a first-line bDMARD in 38% of patients, as a second-line in 34% and as a ≥ hird-line in 28%. The percentage of patients achieving low disease activity (BASDAI<4) increased from 9% at baseline to 48% at month 6 and was maintained (49%) up to month 24. The greatest improvement in BASDAI was observed in naïve patients (month 6: -2.6; month 24: -3.7), followed by second-line (month 6: -1.9; month 24: -3.1) and ≥ third-line (month 6: -1.3; month 24: -2.3) patients. Reductions in mean pain VAS (-23.3; -31.9), ptGA (-25.1; -31.9) and phGA (-25.1; -31) were also observed at 6 and 24 months. Secukinumab showed an overall 12-months persistence rate of 70% (95% confidence interval [CI]: 63-77%) and a 24-months persistence rate of 58% (95% CI, 51-66%). Patients receiving first-line secukinumab had the highest 24-months persistence rate (p = 0.05).

Conclusion: Secukinumab improved disease activity in axSpA patients, especially in naive, and second-line patients, which was accompanied by high persistence rates up to 24 months.

Keywords: ankylosing spondylitis; axial spondyloarthritis; effectiveness; non-radiographic axial spondyloarthritis; real-world evidence; secukinumab.

Copyright © 2023 Sivera, Núñez-Monje, Campos-Fernández, Balaguer-Trull, Robustillo-Villarino, Aguilar-Zamora, Garijo-Bufort, López-Gómez, Peña-González, de la Morena, Bedoya-Sanchís, Yankova-Komsalova, Conesa-Mateos, Martínez-Cristóbal, Navarro-Blasco, Senabre-Gallego and Alegre-Sancho.