One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study
Maria Sole Chimenti, Giulia Lavinia Fonti, Paola Conigliaro, Flavia Sunzini, Rossana Scrivo, Luca Navarini, Paola Triggianese, Giusy Peluso, Palma Scolieri, Rosalba Caccavale, Andrea Picchianti Diamanti, Erica De Martino, Simonetta Salemi, Domenico Birra, Alessio Altobelli, Marino Paroli, Vincenzo Bruzzese, Bruno Laganà, Elisa Gremese, Fabrizio Conti, Antonella Afeltra, Roberto Perricone
Abstract
Background Secukinumab (SEC) is effective for ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomized trials, but real-life data are lacking.Research design and methods Real-life, prospective observational study on 169 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 130 PsA, 77%).Results Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes like VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R2 = 0.4; p = 0.009) and peripheral joint involvement (R2 = 0.4; p = 0.04). During follow-up, reduction of BASDAI positively correlated with high ESR (R2 = 0.65; p = 0.04). ASDAS-CRP at T0 positively correlated with high ESR (R2 = 0.34; p = 0.004). Reduction of ASDAS-CRP from T0 to T6 correlated with current smoking status (R2 = 0.42; p = 0.003). In PsA patients, reduction of DAPSA score from T0 to T12 is negatively correlated with the presence of metabolic syndrome (R2 = 0.41; p = 0.0025). SEC was well tolerated; 10 patients discontinued treatment for non-severe adverse events.Conclusions Secukinumab is effective and safe in patients with AS and PsA in a real-life setting.