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Drug retention rate and predictive factors of drug survival for secukinumab in radiographic axial spondyloarthritis

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Abstract

The drug retention rate has been an important indicator for evaluating the treatment tolerance. Unfortunately, our knowledge of the secukinumab retention rate in radiographic axial spondyloarthritis (r-AxSpA) is limited. The objective of this study was to assess the retention rate of secukinumab and evaluate predictive factors of drug survival based on data from a real-life cohort. We retrospectively assessed 147 r-AxSpA patients between May 2018 and January 2020 from the HUR-BIO database. Secukinumab retention rates were analyzed using the Kaplan–Meier method and Cox proportional hazard model was used for predictors factors. The global retention rate of secukinumab was 55% at 12 months. r-AxSpA patients with obesity had a lower frequency of secukinumab discontinuation (29% vs. 50%, p = 0.013) in comparison r-AxSpA patients without obesity. In multivariate analysis, multiple TNFi usage had a higher risk of secukinumab discontinuation [HR 1.99 (1.09–3.62), p = 0.024]; on the other hand, obesity had a lower risk [HR 0.45 (0.27–0.90), p = 0.008]. Except for not using multiple TNFi, this real-life analysis showed for the first time that obesity is not an adverse risk factor for secukinumab drug retention in r-AxSpA. Secukinumab, which is an interleukin-17A inhibitor, could act via a different pathway than tumor necrosis factor inhibitors (TNFi). The identification of predictive factors such as obesity that may affect the individual drug selection may provide more appropriate biologic treatment strategies for r-AxSpA.

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Authors and Affiliations

  1. Ankara City Hospital, Rheumatology Clinic, Ankara, 06100, Turkey

    Berkan Armağan

  2. Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey

    Levent Kılıç, Bayram Farisoğulları, Gözde Kübra Yardımcı, Emre Bilgin, Ertuğrul Çağrı Bölek, Ömer Karadağ, Şule Apraş Bilgen, Sedat Kiraz, İhsan Ertenli & Umut Kalyoncu

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All co-authors take full responsibility for the integrity and accuracy of all aspects of this work. All authors made substantial contributions to the conception and design of the study, and/or acquisition of data, and/or analysis and interpretation of data; all authors participated in drafting the article or revising it critically for important intellectual content and gave final approval of the version to be submitted.

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Armağan, B., Kılıç, L., Farisoğulları, B. et al. Drug retention rate and predictive factors of drug survival for secukinumab in radiographic axial spondyloarthritis. Rheumatol Int 43, 147–156 (2023). https://doi.org/10.1007/s00296-022-05213-1

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