Predictors of Survival of Secukinumab Treatment in a Multicenter Cohort of 556 Spondylarthritis

Benoit Flachaire¹, Jean-Guillaume Letarouilly ², Céline Labadie ³, Nicolas Cohen ⁴, Vincent Pradel ⁵, Jérémie Sellam ⁶, Pascal Richette ⁷, Philippe Dieudé ⁸, Pascal Claudepierre ⁹, Bruno Fautrel ¹⁰, Eric Houvenagel ¹¹, Chi Duc Nguyen ¹², Marie-Hélène Guyot ¹³, Nicolas Segaud ¹⁴, Frédéric Maury ¹⁵, Laurent Marguerie ¹⁶, Xavier Deprez ¹⁷, Jean-Hugues Salmon ¹⁸, Guy Baudens ¹⁹, Elisabeth Gervais ²⁰, Corinne Miceli-Richard ²¹, Isabelle Chary-Valckenaere ²², Pierre Lafforgue ²³, Damien Loeuille ²⁴, Christophe Richez ²⁵, René-Marc Flipo ²⁶ and Thao Pham ²³, ¹Aix-Marseille University, CHU Marseille, department of Rheumatology, 13,000 Marseille, France, Marseille, Provence-Alpes-Cote d'Azur, France, ²University of Lille, CHU Lille, department of rheumatology, 59,000 Lille, France, Lille, Nord-Pas-de-Calais, France, ³Bordeaux University, CHU Bordeaux, department of Rheumatology, 33,000 Bordeaux, France, Bordeaux, Aquitaine, France, ⁴APHM -Assistance publique des hôpitaux de Marseille, Marseille, France, ⁵APHM -Assistance publique des hôpitaux de Marseille, Marseille, Finland, ⁶Service de Rhumatologie, AP-HP Hôpital Saint-Antoine, Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, Paris, France, Paris, France, ⁷Department of Rheumatology, AP-HP Lariboisiere Hospital, Paris, France, ⁸Rheumatology, Bichat Hospital, APHP, Paris;, Paris, France, ⁹Rheumatology, CHU Henri Mondor Créteil, Paris, France, ¹⁰Pitié-Salpêtrière Hospital, Department of Rheumatology, AP-HP, Sorbonne University, UPMC university, Paris, Ile-de-France, France, ¹¹Rheumatology, Saint Philibert Hospital, Lille Cathololic Institute, Lomme, Lomme, France, ¹²Rheumatology, Hospital of Béthune, Béthune, Béthune, France, ¹³Rheumatology, Hospital of Roubaix, Roubaix, Roubaix, France, ¹⁴Internal Medicine, Hospital of Armentières, Armentières, Armentières, France, ¹⁵Rheumatology, Private Practice, Beuvry, Beuvry, France, ¹⁶Rheumatology, Calot Institute, Berck, Berck-sur-Mer, ¹⁷Rheumatology, Hospital of Valenciennes, Valenciennes, Valenciennes, France, ¹⁸Rheumatology, Reims University Hospital, Reims, Reims, France, ¹⁹Rheumatology, Private Practice, Valenciennes, Valenciennes, France, ²⁰CHU de Poitiers, Rheumatology, Poitiers, France, ²¹Paris Descartes University, Department of Rheumatology - Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, ²²Centre Hospitalier Universitaire de Nancy, VANDOEUVRE, France, ²³Aix-Marseille University, CHU Marseille, department of Rheumatology, 13,000 Marseille, France, Marseille, France, ²⁴Rheumatology, Nancy University Hospital and and UMR 7365 CNRS-UL IMoPA, Université de Lorraine, VANDOEUVRE, France, ²⁵Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France, ²⁶University of Lille, CHU Lille, department of rheumatology, 59,000 Lille, France, Lille, France

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: drug survival, psoriatic arthritis and predictifs factors, secukinumab, Spondylarthritis

Session Information

Date: Sunday, November 10, 2019

Title: 3S111: Spondyloarthritis Including Psoriatic Arthritis – Clinical II: Axial Spondyloarthritis Treatment (933–938)

Session Type: ACR Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: Secukinumab (SEC) is an interleukin-17 inhibitor used to treat patients with axial spondylarthritis (axSpA) and psoriatic arthritis (PsA). Drug survival is often used as a proxy for treatment effectiveness and safety. We aim to assess SEC survival in routine clinical practice and to identify survival predictors associated.

Methods: We conducted a retrospective, longitudinal, observational, multicentric study including all patients with axSpA or PsA who received at least 1 injection of SEC between July 2016 and April 2019. We collected demographic and clinical characteristics, onset date, initial dosage and dosage modification of SEC, previous biologic Disease-modifying antirheumatic drugs (bDMARDs) and concomitant treatments. We classified the reason of discontinuation in lack of effectiveness, adverse events and others. Potential predictors evaluated were baseline age, gender, smoking status, previous bDMARDs and concomitant treatment. Among the axSpA cohort, evidence of radiographic sacroiliitis, MRI sacroiliitis or elevated CRP were also assessed as potential predictors. Drug survival was analyzed by the Kaplan-Meier method and differences of survival between groups was assessed by log-rank test.

Results: The main characteristics of the 556 patients (pts) included were the following: 338 (61%) axSpA , 183 (33%) PsA, 324 (58%) female, mean age 47 +/- 12 years, 221 (40%) smokers,160 (29%) radiographic sacroiliitis, 238 (43%) MRI sacroiliitis, 206 (37%) elevated CRP, 239 (43%) HLA B27 positive, mean BASDAI 48,9 +/-27%. SEC was associated to methotrexate (MTX) in 140 pts (25%) and was the first line bDMARD in 56 patients (10%).

The median drug survival (MDS) of SEC was 76 weeks (w) (interquartile range [65-88]). At 52w, 245 pts (60%) SpA were still treated with SEC. Among reasons of discontinuation, 172 (68%) pts discontinued SEC for lack of effectiveness, 46 (18%) for adverse events and 13 (5.1%) for others.

First line SEC administration was associated with a longer survival versus second line and more: 111w [83-138] vs 69w [57-81] (p=0.01) (figure 1). MDS was not significantly different according to gender, disease, MTX combo, elevated CRP, axSpA vs PsA and smoking status.

Among the axSpA pts, absence of radiographic or MRI sacroiliitis and normal CRP did not modify significantly SEC survival (p=0.85) (figure2).

Conclusion: In routine clinical practice, SEC median survival was 76 weeks. Fist line administration was associated with improved SEC retention. Lack of effectiveness was the most common reason of discontinuation.

Disclosure: B. Flachaire, UCB pharma, BMS, Novartis, 9; J. Letarouilly, None; C. Labadie, None; N. Cohen, None; V. Pradel, None; J. Sellam, Janssen, 8; P. Richette, Janssen, 8; P. Dieudé, None; P. Claudepierre, Janssen, 8; B. Fautrel, AbbVie, 2, 5, 8, Biogen, 5, 8, BMS, 5, 8, Boehringer Ingelheim, 8, Celgene, 5, 8, Eli Lilly and Company, 2, 5, Janssen, 5, 8, Lilly, 8, Medac, 5, 8, MSD, 2, 5, 8, NORDIC Pharma, 5, 8, Novartis, 5, 8, Pfizer, 2, 5, 8, Roche, 5, 8, Sanofi-Aventis, 5, SOBI, 5, 8, UCB, 5, 8; E. Houvenagel, Janssen, 8, Novartis, 8; C. Nguyen, None; M. Guyot, None; N. Segaud, None; F. Maury, None; L. Marguerie, None; X. Deprez, Janssen, 8; J. Salmon, Janssen, 8; G. Baudens, None; E. Gervais, None; C. Miceli-Richard, Abbott, Bristol-Myers Squibb, Merck, Pfizer, Roche, Schering-Plough, and Wyeth, 8, Abbvie, 2, 5, AbbVie, Bristol-Myers Squibb, Novartis, Merck, Pfizer, and Wyeth, 2, Biogen, 2, BMS, 5, MSD, 2, Novartis, 2, 5, Pfizer, 2, Pfizer, Roche, UCB, Wyeth, and Merck, 5, UCB, 2; I. Chary-Valckenaere, None; P. Lafforgue, Chugai, 8, Amgen, 8, BMS, 8, Lilly, 8, Abbvie, 8, Pfizer, 8, Biogaran, 8; D. Loeuille, None; C. Richez, astrazeneca, 5, 8, BMS, 5, 8, Glenmark, 5, 8, Janssen, 5, 8, Lilly, 5, 8, Pfizer, 5, 8, Roche, 5, 8, UCB, 5, 8; R. Flipo, Janssen, 8, Novartis, 8; T. Pham, Abbvie, 8, Amgen, 8, Biogen, 8, BMS, 8, Celgene, 8, Fresenius-Kabi, 8, Janssen, 8, Lilly, 8, Medac, 8, MSD, 8, Nordic, 8, Novartis, 8, Pfizer, 8, Roche-Chugai, 8, Sandoz, 8, Sanofi, 8, UCB, 8.

To cite this abstract in AMA style:

Flachaire B, Letarouilly J, Labadie C, Cohen N, Pradel V, Sellam J, Richette P, Dieudé P, Claudepierre P, Fautrel B, Houvenagel E, Nguyen C, Guyot M, Segaud N, Maury F, Marguerie L, Deprez X, Salmon J, Baudens G, Gervais E, Miceli-Richard C, Chary-Valckenaere I, Lafforgue P, Loeuille D, Richez C, Flipo R, Pham T. Predictors of Survival of Secukinumab Treatment in a Multicenter Cohort of 556 Spondylarthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/predictors-of-survival-of-secukinumab-treatment-in-a-multicenter-cohort-of-556-spondylarthritis/. Accessed .

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