MADRID—Recent research analyzing the experience of psoriatic arthritis (PsA) patients in Spain using secukinumab was presented during the 2019 European Congress of Rheumatology (EULAR), June 12–15. This investigation was a multi-center, observational, longitudinal, retrospective study conducted in four Madrid-area tertiary hospitals.1 Patients were included if they had PsA and received at least one dose of secukinumab.
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For the study, patient medical records were reviewed to collect demographic and clinical data, features of PsA, including extra-articular involvement and radiological damage. Records also provided information on prior therapies, disease assessment and response data at Month 6 of secukinumab treatment. The Month 6 response data included joint counts, C-reactive protein CRP measures, DAPsA (disease activity in psoriatic arthritis), treatment discontinuation reason(s) and adverse events.
A total of 177 patients, most of whom were female (n=115; 65%), were included in the study. The mean patient age was 53 years old, with an average disease duration of nine years. Most of the patients (n=169; 95%) had peripheral disease, with 34% having joint erosions and 47% (n=84) having axial disease, with 68 of those individuals having radiologic damage. Also, 148 patients (84%) had psoriasis, 61 patients (34%) had dactylitis and 111 patients (63%) had enthesitis. The average body mass index was 28.4, with 37% (n=52) of patients being obese.
Patient co-morbidities included hypertension, diabetes mellitus, dyslipidemia, hepatitis B infection, hepatitis C infection and malignancy. Additionally, 55 patients (31%) were active smokers.
Previous treatment use included conventional disease-modifying antirheumatic drugs (DMARDs) (90%), mostly methotrexate (77%) and biologic DMARDs (67%). Of the patients who had previously used biologic DMARDs, 32% had used one biologic DMARD, 25% had used two biologic DMARDs, 20% had used three biologic DMARDs and 21% had used four or more biologic DMARDs. Sixty-nine percent of patients received 150 mg of secukinumab, and 31% received 300 mg of secukinumab.
At baseline the average tender joint count was seven, the swollen joint count was four, CRP was 7 mg/L and DAPsA was 26.
By Month 6 of secukinumab therapy, the average tender joint count decreased to five, swollen joint count had decreased to two, the CRP level had decreased to 5 mg/L and the DAPsA had decreased to 17.
For the 80 patients with DAPsA data available, 47% (n=38) had DAPsA scores of 14 or less, indicating low disease activity. Nine patients had DAPsA scores of four or less, indicating remission. In biologic DMARD-naive patients, DAPsA was variable, being around 27 at baseline and decreasing to 16 at Month 6. For biologic DMARD-experienced patients, DAPsA varied at Month 6 between 24 and 17. For patients with exposure to three or more biologic DMARDs, the DAPsA at Month 6 varied from 18 to 10.