Predictors of Secukinumab Treatment Response and Continuation in Axial Spondyloarthritis: Results From the EuroSpA Research Collaboration Network

Abstract

<p><b>Objective</b>. In patients with axial spondyloarthritis (axSpA) initiating secukinumab (SEC), we aimed to<br>identify baseline (treatment start) predictors of achieving low disease activity (LDA) after 6 months, as<br>measured by the Axial Spondyloarthritis Disease Activity Score using C-reactive protein (ASDAS-CRP)<br>and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), as well as treatment continuation after<br>12 months.<br><b>Methods</b>. From 11 European registries, patients with axSpA who initiated SEC treatment in routine care,<br>with available data on 6-month ASDAS-CRP and BASDAI assessments were included. Logistic regression<br>analyses on multiply imputed baseline data were performed; potential baseline predictors included demographic, diagnosis, lifestyle, clinical, and patient-reported variables.<br><b>Results</b>. 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.<br><b>Conclusion</b>. In this European real-world study of patients with axSpA initiating SEC, predictors of achieving<br>LDA by ASDAS-CRP and BASDAI at 6 months and remaining on treatment at 12 months included both<br>clinical, patient-reported, and lifestyle factors, underscoring the complex mechanisms of real-world drug<br>effectiveness<br></p>