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Better Clinical Responses for Biologic Naïve AxSpA Patients Treated with Secukinumab

There were no significant safety issues in the group of patients treated with secukinumab for more than 3 years.

Patients with axial spondyloarthrtitis (AxSpA) who have not previously been treated with a biologic are much more likely to have a clinical response from secukinumab, according to new data presented during the 2022 American College of Rheumatology Convergence Meeting in Philadelphia.

A team, led by Semih Gulle, Dokuz Eylul University School of Medicine Division of Rheumatology, evaluated secukinumab in patients with axial spondyloarthrtitis from the TURKBIO cohort.

The TURKBIO Cohort

In the study, the investigators evaluated patients at 6, 12, and 24 months registered in the TURKBIO database for secukinumab drug retention, inactive disease/low disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] < 2/< 4, Ankylosing Spondylitis Disease Activity Score [ASDAS] < 1.3/< 2.1) and response rates (BASDAI50, Spondyloarthritis International Society [ASAS] 20/40, ASDAS clinically significant improvement [ASDAS-CII] and ASDAS major improvement [ASDAS-MI]).

The investigators collected follow-up data from 184 patients with axial spondyloarthritis, 28.3% (n = 52) of which were bDMARD naïve and 71.7% (n = 132) of which had used at least 1 bDMARD prior to secukinumab.

Both groups were similar in age and gender distribution.

Treatment Discontinuation

The 1-year follow-up, 60 patients in the at least 1 bDMARD group and 12 patients in the secukinumab cohort discontinued treatment (P <0.001), largely because of ineffectiveness.

The rate of continuation of secukinumab was 71.7% at the 6 month mark and 60.9% at 12 months.

However, if a patient was assessed for clinical conditions prior to bDMARD use, there was significantly better drug survival rates at 6 months and 12 months in patients naïve to bDMARD (82.7% and 76.9 months, respectively).

One factor examined but not deemed to be impactful was symptoms and the time elapsed following diagnosis, which did not affect the efficacy of the study drug.

For safety, there were no significant issues in the group of patients treated with secukinumab for more than 3 years.

“In a study conducted with TURKBIO real-life data, we found that secukinumab treatment in patients with AxSpA had better clinical response and higher drug survival rates in biologically naive patients, similar to TNFi treatment,” the authors wrote. “However, it has been observed that the use of secukinumab in the second or subsequent steps in patients who do not respond to biologics has similar success rates to TNFi treatment results.”

The study, “Efficacy and Safety of Secukinumab in the Treatment of Axial Spondyloarthritis: Real-Life Data from TURKBIO Cohort,” was published online by ACR.

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