Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study

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 w...

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Main Authors: 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
Format: Article
Language:English
Published: BMJ Publishing Group 2024-09-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/3/e004166.full
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author 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
author_facet 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
author_sort Bente Glintborg
collection DOAJ
description 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.
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spelling doaj-art-8c43513df5124584bc4e451557a862bd2025-08-20T01:51:10ZengBMJ Publishing GroupRMD Open2056-59332024-09-0110310.1136/rmdopen-2024-004166Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational studyBente Glintborg0Merete Lund Hetland1Tore K Kvien2Brigitte Michelsen3Florenzo Iannone4Karel Pavelka5Ziga Rotar6Maria Jose Santos7Catalin Codreanu8Anne Gitte Loft9Maria Sole Chimenti10Gary J Macfarlane11Gareth T Jones12Mikkel Østergaard13Jakub Zavada14Bjorn Gudbjornsson15Gerður Gröndal16Lykke Midtbøll Ørnbjerg17Adrian Ciurea18Daniela Di Giuseppe19Michael J Nissen20Anabela Barcelos21Irene van der Horst-Bruinsma22Sara Nysom Christiansen23Isabel Castrejón24Sella Aarrestad Provan25Heikki Relas26Simon Horskjær Rasmussen27Ismail Sari28Anna-Mari Hokkanen29Johan K Wallman30Sigrid Vorobjov31Marion Pons32Marleen van de Sande33Corina Mogosan34Lucia Otero-Varela35Karin Laas36Yesim Erez37Katja Perdan Pirkmajer381 Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark1 Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark4 Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway1 Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark24 Rheumatology Unit, University of Bari, Bari, ItalyInstitute of Rheumatology, Prague, Czechia14 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, SloveniaDepartment of Rheumatology, Hospital Garcia de Orta EPE, Almada, Portugal12 Faculty of Medicine, University of Iceland, Reykjavik, IcelandDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkRheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Roma, ItalyAberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UKAberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK1 Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark7 Institute of Rheumatology, Prague, Czech Republic12 Faculty of Medicine, University of Iceland, Reykjavik, IcelandLandspitali University Hospital, Reykjavk, IcelandCopenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark25 Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland3 Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Solna, SwedenDepartment of Rheumatology, Geneva University Hospitals, Geneve, SwitzerlandRheumatology Department, Centro Hospitalar do Baixo Vouga EPE, Aveiro, PortugalDepartment of Rheumatology, Radboud University Medical Centre, Nijmegen, The Netherlands3 Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Copenhagen, DenmarkRheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain4 Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, NorwayInflammation Center, Rheumatology, Helsinki University Central Hospital, Helsinki, FinlandCopenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, DenmarkDivision of Rheumatology, Dokuz Eylul Universitesi Tip Fakultesi, Izmir, TurkeyDepartment of Medicine, Helsinki University and Helsinki University Hospital, Helsinki, Finland6 Department of Clinical Sciences Lund, Rheumatology, Skåne University Hospital, Lund University, Lund, SwedenNational Institute for Health Development, Tallinn, Estonia1 Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Rigshospitalet, Glostrup, DenmarkDepartment of Rheumatology, Amsterdam University Medical Center, Amsterdam, NetherlandsCenter for Rheumatic Diseases, University of Medicine and Pharmacy Carol Davila Bucharest, Bucuresti, RomaniaResearch Unit, Fundación Española de Reumatología, Madrid, SpainDepartment of Rheumatology, East Tallinn Central Hospital, Tallinn, EstoniaDepartment of Rheumatology, Bakircay Universitesi, Izmir, Turkey14 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, SloveniaObjectives 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.https://rmdopen.bmj.com/content/10/3/e004166.full
spellingShingle 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
Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
RMD Open
title Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
title_full Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
title_fullStr Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
title_full_unstemmed Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
title_short Effectiveness of secukinumab in radiographic and non-radiographic axial spondyloarthritis: a European routine-care observational study
title_sort effectiveness of secukinumab in radiographic and non radiographic axial spondyloarthritis a european routine care observational study
url https://rmdopen.bmj.com/content/10/3/e004166.full
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