Predictors of Secukinumab Treatment Response and Continuation in Axial Spondyloarthritis: Results From the EuroSpA Research Collaboration Network.
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Pons Marion, Georgiadis Stylianos, Hetland Merete Lund, Ahmadzay Zohra Faizy, Rasmussen Simon, Christiansen Sara N, Di Giuseppe Daniela, Wallman Johan K, Pavelka Karel, Závada Jakub, Codreanu Catalin, Glintborg Bente, Loft Anne G, Santos Helena, Lourenço Maria H, Nissen Michael J, Ciurea Adrian, Kuusalo Laura, Rantalaiho Vappu, Michelsen Brigitte, Mielnik Pawel, Pirkmajer Katja P, Rotar Ziga, Gudbjornsson Bjorn, Palsson Olafur, van der Horst-Bruinsma Irene, van de Sande Marleen, Castrejón Isabel, Macfarlane Gary J, Laas Karin, Østergaard Mikkel, Ørnbjerg Lykke M
Аннотация
METHODS: From 11 European registries, patients with axSpA who initiated SEC treatment in routine care, with available data on 6-month ASDAS-CRP and BASDAI assessments were included. Logistic regression analyses on multiply imputed baseline data were performed; potential baseline predictors included demographic, diagnosis, lifestyle, clinical, and patient-reported variables.
RESULTS: In a pooled cohort of 1174 patients with axSpA, 5 of 19 potential assessed variables were mutually predictive for achieving LDA by ASDAS-CRP and BASDAI: higher physician global assessment score, noncurrent smoking, lack of prior exposure to biologic/targeted synthetic disease-modifying antirheumatic drugs, and lower Health Assessment Questionnaire scores and BASDAI scores. Moreover, radiographic axSpA and CRP ≤ 10 mg/L were associated with achieving ASDAS-CRP LDA, and HLA-B27 positivity and history of psoriasis with achieving BASDAI LDA, whereas earlier time of secukinumab initiation (2015-2017) was associated with treatment continuation.
CONCLUSION: In this European real-world study of patients with axSpA initiating SEC, predictors of achieving LDA by ASDAS-CRP and BASDAI at 6 months and remaining on treatment at 12 months included both clinical, patient-reported, and lifestyle factors, underscoring the complex mechanisms of real-world drug effectiveness.