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Clinical experience in the long-term treatment of axial spondyloarthritis with secukinumab


Authors: K. Pavelka 1;  Z. Křístková 2;  L. Nekvindová 2
Authors‘ workplace: Revmatologický ústav Praha 1;  Institut biostatistiky a analýz, s. r. o., Brno 2
Published in: Čes. Revmatol., 28, 2020, No. 4, p. 206-215.
Category: Original article

Overview

Secukinumab is a monoclonal antibody that inhibits interleukin 17A, which has been introduced into the treatment of axial spondyloarthritis (axSpA) after successful phase III clinical trials. The open-label extension of MEASURE studies 1, 2 and 3 demonstrated the long-term efficacy and safety of the drug.

The aim of the analysis is to evaluate the long-term effectiveness in real clinical practice in the Czech Republic.

Methods: A retrospective, open-label, cohort study of patients with axSpA treated with secukinumab in the national ATTRA registry was performed, in which patients with axSpA (radiographic and non-radiographic axSpA), who met the indication criteria of the Czech Society for Rheumatology for the biological treatment of spondyloarthritis, were monitored and treated. The following indicators were evaluated: survival on treatment, BASDAI, ASDAS, HAQ, and SF-36.

Results: A total of 243 patients with radiographic axSpA were included in the study. The drug survival of secukinumab was 70.8% after 12 months and 63.5% after 24 months of treatment. Clinically significant improvement in ASDAS (≥ 1.1) was achieved in 71.7% of patients. The HAQ score decreased from a mean of 1.3 ± 0.6 to 0.8 ± 0.6 during the first 2 years of treatment. Furthermore, all quality of life parameters evaluated by SF-36 were improved. The ability to work was another parameter evaluating the quality of life. During the 2-year treatment, 37.7% of patients with disabilities or incapacity for work regained their ability to work. On the contrary, 15.7% of working patients or job-seekers lost their ability to work. The safety of the treatment was good, and no new signs of toxicity appeared. In the non-radiographic axSpA group, only 29 patients with similar results have been monitored and treated to date.

Conclusion: Treatment survival, efficacy, and safety of secukinumab in real clinical practice are very good, and secukinumab represents a new therapeutic alternative for active axial SpA.

Keywords:

axial spondyloarthritis – biological therapy – secukinumab


Sources

1. Ramiro S, van der Heijde D, van Tubergen A, et al. Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort. Ann Rheum Dis 2014; 73: 1455–1461.

2. Dougados M, Baeten D. Spondyloarthritis. Lancet 2011; 377: 2127–2137.

3. van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 2017; 76: 978–991.

4. Braun J, Kiltz U, Heldmann F, et al. Emerging drugs for the treatment of axial and peripheral spondyloarthritis. Expert Opin Emerg Drugs 2015; 20: 1–14.

5. Baraliakos X, Listing J, Fritz C, et al. Persistent clinical efficacy and safety of infliximab in ankylosing spondylitis after 8 years – early clinical response predicts long-term outcome. Rheumatology 2011; 50: 1690–1699.

6. Baeten D, Sieper J, Braun J, et al. Secukinumab, an interleukin 17A inhibitor, in ankylosing spondylitis. N Engl J Med 2015; 373: 2534–2548.

7. Baraliakos X, Braun J, Deodhar A, et al. Long-term efficacy and safety of secukinumab 150 mg in ankylosing spondylitis: 5-year results from the phase III MEASURE 1 extension study. RMD Open 2019. doi:10.1136/rmdopen-2019-001005

8. Marzo-Ortega H, Sieper J, Kivitz A, et al. 5-year efficacy and safety of secukinumab in patients with ankylosing spondylitis: end-of-study results from the phase 3 MEASURE 2 trial. Rheumatology 2020; 2: e339–e346.

9. Pavelka K, Kivitz AJ, Dokoupilová E, et al. Secukinumab 150/300 mg provides sustained improvements in the signs and symptoms of active ankylosing spondylitis: 3-year results from the phase 3 MEASURE 3 study. ACR Open Rheumatol 2020; 2020; 2(2): 119–127.

10. Pavelka K. Doporučení České revmatologické společnosti pro léčbu ankylozující spondylitidy. Čes. Revmatol. 2012; 1: 4–11.

11. Deodhar A, Braun J, Inman RD, et al. Golimumab administered subcutaneously every 4 weeks in ankylosing spondylitis: 5 year results of GO-RAISE study. Ann Rheum Dis 2015; 74: 757–761.

12. van der Heijde D, Dougados M, Landewe R, et al. Sustained efficacy, safety and patient reported outcomes of certolizumab pegol in axial spondyloarthritis. 4 year outcomes of the GO-RAISE study. Ann Rheum Dis 2015; 74: 757–761.

13. Michelsen B , Lindström U, Codreanu C, et al. Drug retention, inactive disease and response rates in 1860 patients with axial spondyloarthritis initiating secukinumab treatment – routine care data from 13 registries in the EuroSpA collaboration. RMD Open 2020; 6(3): e001280.

14. Smolen J, Breedveld FC, Burmestr GR, et al. Treating rheumatoid arthritis to target. 2014update of the recommendations of an international task force Ann Rheum Dis 2016; 75: 3–15.

15. Smolen J, Schools M, Braun J, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis to target. 2017 update of recommendations by international task force. Ann Rheum Dis 2018; 77: 3–17.

16. Garret S, Jenkinson T, Kennedy LG, et al. A new approach to defining disease status in ankylosing spondylitis. The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994; 21: 2286–2291.

17. Lukas C, Landewe R, Sieper J, et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 2009; 68: 18–24.

18. Liew JW, Dubreuil M. Treat to target in axial spondyloarthritis. Pros Cons and future directions. Rheum Dis Clin N Am 2020; 46: 343–356.

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Dermatology & STDs Paediatric rheumatology Rheumatology

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Czech Rheumatology

Issue 4

2020 Issue 4

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