Abstract
Objective To describe the access, effectiveness, survival and adverse events (AE) of secukinumab (SEC) in patients with axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA).
Methods A multicentre, observational, retrospective cohort study. Patients ≥18 years with axSpA) and patients with PsA with axial involvement who had received at least one dose of SEC were included. The number of days elapsed between the request for the drug and the first application was calculated. Effectiveness was defined as BASDAI < 4 at six months. Drug survival was analysed using Kaplan-Meier curves and Cox regression analysis.
Results One hundred seventeen patients were included, 72 (61.5%) with axPsA and 45 (38.5%) with axSpA. Those having public health insurance presented a longer delay in receiving SEC 90 days (IQR 60-150) vs those with social security (p=0.01) and those with private health coverage (p=0.009). Effectiveness of SEC after 6 months was achieved in 72 (61.5%) patients, 44 (61.5%) patients with axial PsA and 28 (62.2%) patients with axSpA, (p=0.91). The median SEC survival was 48 months (95% CI 32-63). The only factor associated with reduced survival was SEC being given in the third or higher line of treatment (HR 3.43, 95%CI 1.11-11.10, p=0.04). The incidence of AE was 7.9 events per 100 patients/year (CI 95% 5-12).
Conclusion The delay in receiving SEC was longer in patients with public health insurance. Patients using SEC as third-line or higher therapy had 3.4 times less survival. AE were mild and no AE of interest were observed.
