Secukinumab retention rate is greater in patients with psoriatic arthritis presenting with axial involvement

Submitted: 28 January 2023
Accepted: 14 April 2023
Published: 8 May 2023
Abstract Views: 912
PDF: 469
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Psoriatic arthritis (PsA) is an inflammatory disease characterized by peripheral and axial involvement. Biological disease-modifying antirheumatic drugs (bDMARDs) are the mainstream treatment for PsA and bDMARDs retention rate is a proxy for the drug’s overall effectiveness. However, it is unclear whether IL-17 inhibitors can have a higher retention rate than tumor necrosis factor (TNF) inhibitors, in particular in axial or peripheral PsA. A real-life observational study was conducted on bDMARD naïve PsA patients initiating TNF inhibitors or secukinumab. Time-to-switch analysis was carried out with Kaplan-Meyer curves (log-rank test) truncated at 3 years (1095 days). Sub-analyses of Kaplan-Meyer curves between patients presenting with prevalent peripheral PsA or prevalent axial PsA were also conducted. Cox regression models were employed to describe predictors of treatment switch/swap. Data on 269 patients with PsA naïve to bDMARD starting either TNF inhibitors (n=220) or secukinumab (n=48) were retrieved. The overall treatment retention at 1 and 2 years was similar for secukinumab and TNF inhibitors (log-rank test p NS). We found a trend towards significance in the Kaplan-Meyer at 3 years in favor of secukinumab (log-rank test p 0.081). Predominant axial disease was significantly associated with a higher chance of drug survival in secukinumab users (adjusted hazard ratio 0.15, 95% confidence interval = 0.04-0.54) but not in TNF inhibitor users. In this real-life, single-center, study on bDMARD naïve PsA patients, axial involvement was associated with longer survival of secukinumab but not of TNF inhibitors. Drug retention of secukinumab and TNF inhibitors were similar in predominantly peripheral PsA.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Gossec L, Baraliakos X, Kerschbaumer A, de Wit M, McInnes I, Dougados M, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020; 79: 700-12. DOI: https://doi.org/10.1136/annrheumdis-2020-217163
Jandus C, Bioley G, Rivals J-P, Dudler J, Speiser D, Romero P. Increased numbers of circulating polyfunctional Th17 memory cells in patients with seronegative spondylarthritides. Arthritis Rheum. 2008; 58: 2307-17. DOI: https://doi.org/10.1002/art.23655
Baraliakos X, Gossec L, Pournara E, Jeka S, Mera-Varela A, D’Angelo S, et al. Secukinumab in patients with psoriatic arthritis and axial manifestations: results from the double-blind, randomised, phase 3 MAXIMISE trial. Ann Rheum Dis. 2021; 80: 582-90. DOI: https://doi.org/10.1136/annrheumdis-2020-218808
Purmonen T, Puolakka K, Mishra D, Gunda P, Martikainen J. Cost-effectiveness of secukinumab compared to other biologics in the treatment of ankylosing spondylitis in Finland. Clinicoecon Outcomes Res. 2019; 11: 159-68. DOI: https://doi.org/10.2147/CEOR.S192235
Emery P, Van Keep M, Beard S, Graham C, Miles L, Jugl SM, et al. Cost effectiveness of secukinumab for the treatment of active ankylosing spondylitis in the UK. Pharmacoeconomics. 2018; 36: 1015-27. DOI: https://doi.org/10.1007/s40273-018-0675-9
Goeree R, Chiva-Razavi S, Gunda P, Jain M, Jugl SM. Cost-effectiveness analysis of secukinumab in ankylosing spondylitis from the Canadian perspective. J Med Econ. 2019; 22: 45-52. DOI: https://doi.org/10.1080/13696998.2018.1539400
Mease PJ, Landewé R, Rahman P, Tahir H, Singhal A, Boettcher E, et al. Secukinumab provides sustained improvement in signs and symptoms and low radiographic progression in patients with psoriatic arthritis: 2-year (end-of-study) results from the FUTURE 5 study. RMD Open. 2021; 7: e001600. DOI: https://doi.org/10.1136/rmdopen-2021-001600
Baraliakos X, Gensler LS, D’Angelo S, Iannone F, Favalli EG, de Peyrecave N, et al. Biologic therapy and spinal radiographic progression in patients with axial spondyloarthritis: a structured literature review. Ther Adv Musculoskelet Dis. 2020; 12: 1759720X20906040. DOI: https://doi.org/10.1177/1759720X20906040
Karmacharya P, Duarte-Garcia A, Dubreuil M, Murad MH, Shahukhal R, Shrestha P et al. Effect of therapy on radiographic progression in axial spondyloarthritis: a systematic review and meta-analysis. Arthritis Rheumatol. 2020; 72: 733-49. DOI: https://doi.org/10.1002/art.41206
Adami G. Regulation of bone mass in inflammatory diseases. Best Pract Res Clin Endocrinol Metab. 2021; 36: 101611. DOI: https://doi.org/10.1016/j.beem.2021.101611
Fassio A, Idolazzi L, Viapiana O, Benini C, Vantaggiato E, Bertoldo F, et al. In psoriatic arthritis Dkk-1 and PTH are lower than in rheumatoid arthritis and healthy controls. Clin Rheumatol. 2017; 36: 2377-81. DOI: https://doi.org/10.1007/s10067-017-3734-2
Orsolini O, Adami G, Rossini M, Ghellere F, Caimmi C, Fassio A, et al. Parathyroid hormone is a determinant of serum Dickkopf-1 levels in ankylosing spondylitis. Clin Rheumatol. 2018; 37: 3093-8. DOI: https://doi.org/10.1007/s10067-018-4205-0
Rossini M, Viapiana O, Idolazzi L, Ghellere F, Fracassi E, Troplini S, et al. Higher level of Dickkopf-1 is associated with Low bone mineral density and higher prevalence of vertebral fractures in patients with ankylosing spondylitis. Calcif Tissue Int. 2016; 98: 438-45. DOI: https://doi.org/10.1007/s00223-015-0093-3
Adami G, Orsolini G, Adami S, Viapiana O, Idolazzi L, Gatti D, et al. Effects of TNF inhibitors on Parathyroid hormone and wnt signaling antagonists in rheumatoid arthritis. Calcif Tissue Int. 2016; 99: 360-4. DOI: https://doi.org/10.1007/s00223-016-0161-3
Orsolini G, Adami G, Adami S, Viapiana O, Idolazzi L, Gatti D, et al. Short-term effects of TNF inhibitors on bone turnover markers and bone mineral density in rheumatoid arthritis. Calcif Tissue Int. 2016; 98: 580-5. DOI: https://doi.org/10.1007/s00223-016-0114-x
Fassio A, Adami G, Gatti D, Orsolini G, Giollo A, Idolazzi L, et al. Inhibition of tumor necrosis factor-alpha (TNF-alpha) in patients with early rheumatoid arthritis results in acute changes of bone modulators. Int Immunopharmacol. 2018; 67: 487-9. DOI: https://doi.org/10.1016/j.intimp.2018.12.050
Ramonda R, Lorenzin M, Carriero A, Chimenti MS, Scarpa R, Marchesoni A, et al. Effectiveness and safety of secukinumab in 608 patients with psoriatic arthritis in real life: a 24-month prospective, multicentre study. RMD Open. 2021; 7: e001519. DOI: https://doi.org/10.1136/rmdopen-2020-001519
Alonso S, Villa I, Fernández S, Martín JL, Charca L, Pino M, et al. Multicenter study of secukinumab survival and safety in spondyloarthritis and psoriatic arthritis: secukinumab in Cantabria and ASTURias study. Front Med (Lausanne). 2021; 8: 679009. DOI: https://doi.org/10.3389/fmed.2021.679009
Diaz P, Feld J, Eshed I, Eder L. Characterising axial psoriatic arthritis: correlation between whole spine MRI abnormalities and clinical, laboratory and radiographic findings. RMD Open. 2022; 8: e002011. DOI: https://doi.org/10.1136/rmdopen-2021-002011
Costa L, Perricone C, Chimenti MS, Del Puente A, Caso P, Peluso R, et al. Switching between biological treatments in psoriatic arthritis: a review of the evidence. Drugs R D. 2017; 17: 509-22. DOI: https://doi.org/10.1007/s40268-017-0215-7
Lorenzin M, Ortolan A, Cozzi G, Calligaro A, Favaro M, Del Ross T, et al. Predictive factors for switching in patients with psoriatic arthritis undergoing anti-TNFα, anti-IL12/23, or anti-IL17 drugs: a 15-year monocentric real-life study. Clin Rheumatol. 2021; 40: 4569-80. DOI: https://doi.org/10.1007/s10067-021-05799-0
Ortolan A, Lorenzin M, Leo G, Pampaloni F, Messina F, Doria A, et al. Secukinumab drug survival in psoriasis and psoriatic arthritis patients: a 24-month real-life study. Dermatology. 2022; 238: 897-903. DOI: https://doi.org/10.1159/000522008

How to Cite

Adami, G., Idolazzi, L., Benini, C., Fracassi, E., Carletto, A., Viapiana, O., Gatti, D., Rossini, M., & Fassio, A. (2023). Secukinumab retention rate is greater in patients with psoriatic arthritis presenting with axial involvement. Reumatismo, 75(1). https://doi.org/10.4081/reumatismo.2023.1559