Secukinumab after first-line tumor necrosis factor-alpha inhibitor therapy in psoriatic arthritis: A real-world retrospective cohort study.

Objectives: This study compared the secukinumab treatment responses and adverse effects in psoriatic arthritis patients who received secukinumab as second-line with those that received secukinumab after two or more tumor necrosis factor-alpha (TNF-α) inhibitors. Patients and methods: The retrospective study included 68 psoriatic arthritis patients followed up between October 2018 and October 2021. The patients were divided into two groups according to their anti-TNF-α treatment history. Group 1 consisted of 29 patients (11 males, 18 females; mean age: 45.3±13.3 years; range, 21 to 69 years) who had previously received one anti-TNF-α agent, while Group 2 included 39 patients (18 males, 21 females; mean age: 46.4±13.0 years; range, 24 to 70 years) who had been treated with two or more anti-TNF-α agents. Treatment responses of the groups were measured and compared using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Visual Analog Scale (VAS). A posttreatment BASDAI score ≤4 was used as a criterion for remission. Results: The mean duration of secukinumab treatment was 16.6±12.7 months for Group 1 and 16.0±11.6 months for Group 2 (p=0.84). Both groups responded significantly to secukinumab in terms of BASDAI and VAS scores (p<0.001 and p<0.001, respectively). Group 1 had a greater decline in BASDAI and VAS scores than Group 2 (p=0.045 and p=0.032, respectively). Furthermore, the remission rate was greater in Group 1 compared to Group 2 (58% vs. 34%, p=0.03). The adverse effects of secukinumab treatment were an allergic reaction in Group 1 and one case of ulcerative colitis in Group 2. Conclusion: Second-line secukinumab treatment resulted in a greater decline in BASDAI and VAS scores. Moreover, secukinumab achieved a significantly higher rate of remission when it was used as second-line therapy after one anti-TNF-α agent.

When to start secukinumab treatment in patients with axial spondyloarthropathy: Before or after anti-TNFα treatment? / ¿Cuándo iniciar el tratamiento con secukinumab en pacientes con espondiloartropatía axial: antes o después del tratamiento anti-TNFα?

Introduction and objectives: This study aimed to evaluate the efficacy of secukinumab (SEC) in axial spondyloarthropathy (axSpA) in anti-TNFα naïve and anti-TNFα experienced patients. It also focused on the duration of SEC treatment and its side effects. Patients and methods: The patients with axSpA treated with SEC and followed up in our outpatient clinic from May 2018 through October 2021 were included in this study. All patients in the study also fulfilled the ASAS classification criteria for axSpA. Patients were separated into two groups according to whether they received prior anti-TNFα therapy. While anti-TNFα naïve patients comprised group 1, anti-TNFα experienced patients were included in group 2. Pre- and post-treatment BASDAI scores were reported and compared. Results: Eighty-four axSpA patients (42 men; duration of the disease: 86.86±65.35 months in group 1 and 160.65±97.4 months in group 2) were treated with SEC. 45.5% of anti-TNFα naïve patients and 56.5% of anti-TNFα experienced patients were still on SEC therapy in October 2021. Duration of SEC treatment was 12.5±7.9 months in group 1 and 17.19±12 months in group 2 (p=0.098). The differences between pre-and post-treatment BASDAI scores were statistically significant in both groups (p<0.001). While patients in group 1 did not develop any adverse effects, three patients in group 2 experienced alopecia, uveitis, and recurrent pneumonia after SEC treatment. Conclusion: Our study's efficacy and safety data on the use of SEC were reassuring in both anti-TNFα naïve and anti-TNFα experienced patients. However, further studies are still needed to determine the appropriate timing to begin SEC treatment.(AU)

Antecedentes y objetivo: Este estudio tuvo como objetivo evaluar la eficacia de secukinumab (SEC) en la espondiloartropatía axial (axSpA) en pacientes sin experiencia previa con anti-TNFα y con experiencia con anti-TNFα. También se centró en la duración del tratamiento SEC y sus efectos secundarios. Materiales y métodos: Se incluyeron en este estudio los pacientes con axSpA tratados con SEC y seguidos en nuestra consulta externa desde mayo de 2018 hasta octubre de 2021. Todos los pacientes en el estudio también cumplían con los criterios de clasificación de ASAS para axSpA. Los pacientes se separaron en dos grupos según si habían recibido terapia anti-TNFα previa. Mientras que los pacientes sin tratamiento previo con anti-TNFα comprendían el grupo 1, los pacientes con experiencia con anti-TNFα se incluyeron en el grupo 2. Se informaron y compararon las puntuaciones BASDAI antes y después del tratamiento. Resultados: Ochenta y cuatro pacientes con axSpA (42 hombres; duración de la enfermedad: 86,86 ±65,35 meses en el grupo 1 y 160,65±97,4 meses en el grupo 2) fueron tratados con SEC. El 45,5% de los pacientes sin experiencia previa con anti-TNFα y el 56,5% de los pacientes experimentados con anti-TNFα seguían en tratamiento con SEC en octubre de 2021. La duración del tratamiento con SEC fue de 12,5±7,9 meses en el grupo 1 y de 17,19±12 meses en el grupo 2 (p=0,098). Las diferencias entre las puntuaciones BASDAI antes y después del tratamiento fueron estadísticamente significativas en ambos grupos (p<0,001). Mientras que los pacientes del grupo 1 no desarrollaron ningún efecto adverso, tres pacientes del grupo 2 experimentaron alopecia, uveítis y neumonía recurrente después del tratamiento con SEC. Conclusiones: Los datos de eficacia y seguridad de nuestro estudio sobre el uso de secukinumab fueron alentadores tanto en pacientes sin tratamiento previo con anti-TNFα como en pacientes experimentados con anti-TNFα. Sin embargo, aún se...(AU)

When to start secukinumab treatment in patients with axial spondyloarthropathy: Before or after anti-TNFα treatment?

INTRODUCTION AND OBJECTIVES: This study aimed to evaluate the efficacy of secukinumab (SEC) in axial spondyloarthropathy (axSpA) in anti-TNFα naïve and anti-TNFα experienced patients. It also focused on the duration of SEC treatment and its side effects. PATIENTS AND METHODS: The patients with axSpA treated with SEC and followed up in our outpatient clinic from May 2018 through October 2021 were included in this study. All patients in the study also fulfilled the ASAS classification criteria for axSpA. Patients were separated into two groups according to whether they received prior anti-TNFα therapy. While anti-TNFα naïve patients comprised group 1, anti-TNFα experienced patients were included in group 2. Pre- and post-treatment BASDAI scores were reported and compared. RESULTS: Eighty-four axSpA patients (42 men; duration of the disease: 86.86±65.35 months in group 1 and 160.65±97.4 months in group 2) were treated with SEC. 45.5% of anti-TNFα naïve patients and 56.5% of anti-TNFα experienced patients were still on SEC therapy in October 2021. Duration of SEC treatment was 12.5±7.9 months in group 1 and 17.19±12 months in group 2 (p=0.098). The differences between pre-and post-treatment BASDAI scores were statistically significant in both groups (p<0.001). While patients in group 1 did not develop any adverse effects, three patients in group 2 experienced alopecia, uveitis, and recurrent pneumonia after SEC treatment. CONCLUSION: Our study's efficacy and safety data on the use of SEC were reassuring in both anti-TNFα naïve and anti-TNFα experienced patients. However, further studies are still needed to determine the appropriate timing to begin SEC treatment.