FRI0455\u2005USE OF SECUKINUMAB IN PSORIATIC ARTHRITIS AND ANKYLOSING SPONDYLITIS….REAL WORLD DATA

Abstract

Background Secukinumab was the IL-17 inhibitor licensed for use in Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS). The aim of this study was to evaluate the effectiveness and safety of Secukinumab in our cohort of patients. Objectives In order to assess the effectiveness and safety of Secukinumab, a retrospective analysis of patients treated with this drug in the Northern Health and Social Care Trust was undertaken. Methods Retrospective data was collected from the Local Biologic database. All patients who were on Secukinumab were selected. They were divided into two arms, Psoriatic Arthritis and Ankylosing Spondylitis. From this baseline disease severity was sought, baseline inflammatory markers and patient cohort data was collected. Patients were seen routinely at three monthly intervals and outcomes were collected up to a 12 month period. From patient notes drug response and adverse effects were recorded. Results A total of 41 patients with psoriatic arthritis were treated with Secukinumab over the 12-month period studied. Twenty-six patients were female and fifteen were male, with ages ranging from 26 to 70. Only 12 of the patients were on concomitant methotrexate, all met the NICE start criteria with required DAS 76 scores. Seven of the patients were biologic naïve (17%) at commencement of drug. Of all the patients who responded, most had some response by 3 months, and all had further response by six months. Sixteen patients (39%) discontinued treatment due to no response, one due to increasing shortness of breath, wheeze and rash, and one patient developed colitis. Other side effects were noted, which did not cause the drug to be discontinued. Five patients had rash and urticaria, three reported headaches. Infections were fairly common, five patients had chest infections, four had sinusitis and three had urinary tract infections. Four patients reported thrush, one oral thrush and three vaginal. A total of 18 patients with Ankylosing Spondylitis were commenced on Secukinumab. 11 males and 7 females. A third (6/18) were biologic naïve. Ages ranged from 27 to 65. In the first three months of commencement there was a reduction in BADSAI scores of all patients. This remained at six months. Inflammatory markers CRP and ESR were also reduced. Seven patients discontinued Secukinumab after six months due to side effects or lack or perceived response by the patient (seen in 1 patient). Two patients had a loss of efficacy. The remaining four patients noted cutaneous skin infections, sinus symptoms or headaches as noted in the PsA arm of the audit. Conclusion Patients in the Northern Trust starting Secukinumab generally have severe disease and most have had prior treatment with biologics. There was a high incidence of non responders in this group, however in those patients who responded there was a good response rate at 3 months, and these patients were still on treatment at 12 months. Side effects were as expected, with infections being the most commonly reported side effect. References [1] Robertson J, Tindell A, Crosbie D, Siebert S. Real-world experience of secukinumab for psoriatic arthritis and axial spondyloarthritis. Rheumatology. Volume 57. Issue suppl_3, April 2018. Acknowledgement Department of Rheumatology Antrim Area Hospital Disclosure of Interests None declared