Effectiveness and safety of secukinumab in 608 patients with psoriatic arthritis in real life: a 24-month prospective, multicentre study

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Titel: Effectiveness and safety of secukinumab in 608 patients with psoriatic arthritis in real life: a 24-month prospective, multicentre study
Beteiligte: Ramonda, Roberta; Lorenzin, Mariagrazia; Carriero, Antonio; Chimenti, Maria Sole; Scarpa, Raffaele; Marchesoni, Antonio; Lubrano, Ennio; Salvarani, Carlo; Cauli, Alberto; Semeraro, Angelo; Santo, Leonardo; Ortolan, Augusta; Doria, Andrea; Fracassi, Elena; Virelli, Giulia; Masia, Marco; Fanizzi, Rosalinda; Visalli, Elisa; Amato, Giorgio; Carletto, Antonio; Foti, Rosario
Erschienen: BMJ, 2021
Erschienen in: RMD Open
Sprache: Englisch
DOI: 10.1136/rmdopen-2020-001519
ISSN: 2056-5933
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Beschreibung: <jats:sec><jats:title>Objectives</jats:title><jats:p>To evaluate in a multicentric Italian cohort of patients with psoriatic arthritis (PsA) on secukinumab followed for 24 months: (1) the long-term effectiveness and safety of secukinumab, (2) the drug retention rate and minimal disease activity (MDA), (3) diﬀerences in the outcomes according to the biological treatment line: biologic-naïve patients (<jats:italic>group A</jats:italic>) versus multifailure (<jats:italic>group B</jats:italic>) patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Consecutive patients with PsA receiving secukinumab were evaluated prospectively. Disease characteristics, previous/ongoing treatments, comorbidities and follow-up duration were collected. Disease activity/functional/clinimetric scores and biochemical values were recorded at baseline (T0), 6(T6), 12(T12) and 24(T24) months. Effectiveness was evaluated overtime with descriptive statistics; multivariate Cox and logistic regression models were used to evaluate predictors of drug-discontinuation and MDA at T6. Infections and adverse events were recorded.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>608 patients (41.28% men; mean (SD) age 52.78 (11.33)) were enrolled; secukinumab was prescribed as first-line biological treatment in 227 (37.34%) patients, as second (or more)-line biological treatment in 381 (62.66%). Effectiveness of secukinumab was shown with an improvement in several outcomes, such as Ankylosing Spondylitis Disease Activity Score (T0=3.26 (0.88) vs T24=1.60 (0.69) ;p=0.02) and Disease Activity Index for Psoriatic Arthritis (T0=25.29 (11.14) vs T24=7.69 (4.51); p<0.01). At T24,<jats:italic>group A</jats:italic>showed lower Psoriasis Area Severity Index (p=0.04), erythrocyte sedimentation rate and C reactive protein (p=0.03 ;p=0.05) and joint count (p=0.03) compared with<jats:italic>group B</jats:italic>. At T24, MDA was achieved in 75.71% of<jats:italic>group A</jats:italic>and 70.37% of<jats:italic>group B</jats:italic>. Treatment was discontinued in 123 (20.23%) patients, mainly due to primary/secondary loss of effectiveness, and in 22 due to adverse events. Retention rate at T24 was 71% in the whole population, with some difference depending on secukinumab dosage (p=0.004) and gender (p=0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In a real-life clinical setting, secukimumab proved safe and effective in all PsA domains, with notable drug retention rate.</jats:p></jats:sec>
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