Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
Bente Glintborg,
Merete Lund Hetland,
Tore K Kvien,
Brigitte Michelsen,
Florenzo Iannone,
Karel Pavelka,
Ziga Rotar,
Maria Jose Santos,
Catalin Codreanu,
Anne Gitte Loft,
Maria Sole Chimenti,
Gary J Macfarlane,
Gareth T Jones,
Mikkel Østergaard,
Jakub Zavada,
Bjorn Gudbjornsson,
Gerður Gröndal,
Lykke Midtbøll Ørnbjerg,
Adrian Ciurea,
Daniela Di Giuseppe,
Michael J Nissen,
Anabela Barcelos,
Irene van der Horst-Bruinsma,
Sara Nysom Christiansen,
Isabel Castrejón,
Sella Aarrestad Provan,
Heikki Relas,
Simon Horskjær Rasmussen,
Ismail Sari,
Anna-Mari Hokkanen,
Johan K Wallman,
Sigrid Vorobjov,
Marion Pons,
Marleen van de Sande,
Corina Mogosan,
Lucia Otero-Varela,
Karin Laas,
Yesim Erez,
Katja Perdan Pirkmajer
Affiliations
Bente Glintborg
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Merete Lund Hetland
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Tore K Kvien
Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
Brigitte Michelsen
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Florenzo Iannone
Rheumatology Unit, DiMePRe-J, University of Bari, Bari, Italy
Karel Pavelka
Institute of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, Praha, Czech Republic
Ziga Rotar
Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Maria Jose Santos
Department of Rheumatology, Hospital Garcia de Orta EPE, Almada, Portugal
Catalin Codreanu
Center for Rheumatic Diseases, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania
Anne Gitte Loft
Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
Maria Sole Chimenti
Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Roma, Italy
Gary J Macfarlane
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK
Gareth T Jones
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK
Mikkel Østergaard
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Jakub Zavada
Institute of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, Praha, Czech Republic
Bjorn Gudbjornsson
Centre for Rheumatology Research, Landspitali National University Hospital of Iceland, Reykjavik, Iceland
Gerður Gröndal
Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Lykke Midtbøll Ørnbjerg
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Adrian Ciurea
Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
Daniela Di Giuseppe
Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
Michael J Nissen
Department of Rheumatology, Geneva University Hospitals, Geneve, Switzerland
Anabela Barcelos
Rheumatology Department, Centro Hospitalar do Baixo Vouga EPE, Aveiro, Portugal
Irene van der Horst-Bruinsma
Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands
Sara Nysom Christiansen
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Isabel Castrejón
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Sella Aarrestad Provan
Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
Heikki Relas
Inflammation Center, Rheumatology, Helsinki University Central Hospital, Helsinki, Finland
Simon Horskjær Rasmussen
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Ismail Sari
Division of Rheumatology, Dokuz Eylul Universitesi Tip Fakultesi, Izmir, Turkey
Anna-Mari Hokkanen
Department of Medicine, Helsinki University and Helsinki University Hospital, Helsinki, Finland
Johan K Wallman
Department of Clinical Sciences Lund, Lund University, Lund, Sweden
Sigrid Vorobjov
National Institute for Health Development, Tallinn, Estonia
Marion Pons
Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
Marleen van de Sande
Amsterdam UMC, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Institute for Infection & Immunity, University of Amsterdam, Amsterdam, Netherlands
Corina Mogosan
Center for Rheumatic Diseases, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, Romania
Lucia Otero-Varela
Research Unit, Spanish Society of Rheumatology, Madrid, Spain
Karin Laas
Department of Rheumatology, East Tallinn Central Hospital, Tallinn, Estonia
Yesim Erez
Department of Rheumatology, Bakircay Universitesi, Izmir, Turkey
Katja Perdan Pirkmajer
Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Objectives To compare the treatment effectiveness of secukinumab in radiographic (r) versus non-radiographic (nr) axial spondyloarthritis (axSpA) patients treated in routine care across Europe.Methods Prospectively collected data on secukinumab-treated axSpA patients with known radiographic status were pooled from nine countries.Remission rates based on patient-reported outcomes (PROs; Numeric Rating Scale (0–10), for example, pain ≤2/Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≤2 and Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (ID) <1.3 after 6/12/24 months of secukinumab treatment were calculated.Remission and drug retention rates in r-axSpA versus nr-axSpA patients were compared by logistic and Cox regression models (unadjusted/adjusted for age+sex/adjusted for multiple confounders).Results Overall, 1161 secukinumab-treated patients were included (r-axSpA/nr-axSpA: 922/239). At baseline, r-axSpA patients had longer disease duration and higher C reactive protein, were more often male and HLA-B27 positive and had received fewer prior biological or targeted synthetic disease-modifying antirheumatic drugs compared with nr-axSpA patients, whereas PROs were largely similar.During follow-up, crude PRO remission rates were significantly higher in r-axSpA compared with nr-axSpA patients (6 months: pain≤2: 40%/28%, OR=1.7; BASDAI≤2: 37%/25%, OR=1.8), as were drug retention rates (24 months: 66%/58%, HR 0.73 (ref: r-axSpA)). Proportions of patients achieving ASDAS ID were low for both groups, particularly nr-axSpA (6 months: 11%/8%).However, when adjusting for age+sex, these differences diminished, and after adjusting for multiple confounders, no significant between-group differences remained for either remission or drug retention rates.Conclusion Crude remission/drug retention rates in European secukinumab-treated patients were higher in r-axSpA compared with nr-axSpA patients. In adjusted analyses, secukinumab effectiveness was similar in both groups, suggesting that observed differences were related to factors other than radiographic status.
