One-Year Treatment Outcomes of Secukinumab Versus Tumor Necrosis Factor Inhibitors in Spondyloarthritis: Results From Five Nordic Biologic Registries Including More Than 10,000 Treatment Courses

Danish Rheumatology Database (DANBIO), Anti-Rheumatic Therapy in Sweden/Swedish Rheumatology Quality (ARTIS/SRQ), Center for Rheumatology Research (ICEBIO), Finnish Register of Biological Treatment (ROB-FIN), and Norwegian Antirheumatic Drug Register (NOR-DMARD) registries

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe baseline characteristics and to compare treatment effectiveness of secukinumab versus tumor necrosis factor inhibitors (TNFi) in patients with spondyloarthritis (SpA) using adalimumab as the main comparator. Methods: This was an observational, prospective cohort study. Patients with SpA (clinical ankylosing spondylitis, nonradiographic axial SpA, or undifferentiated SpA) starting secukinumab or a TNFi during 2015–2018 were identified from 5 Nordic clinical rheumatology registries. Data on comorbidities and extraarticular manifestations (psoriasis, uveitis, and inflammatory bowel disease) were captured from national registries (data available in 94% of patients) and included in multivariable analyses. We assessed 1-year treatment retention (crude survival curves, adjusted hazard ratios [HR adj] for treatment discontinuation) and 6-month response rates (Ankylosing Spondylitis Disease Activity Score [ASDAS] score <2.1, Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] <40 mm, crude/LUNDEX-adjusted, adjusted logistic regression analyses with odds ratios [ORs]) stratified by line of biologic treatment (first, second, and third plus). Results: In total, 10,853 treatment courses (842 secukinumab and 10,011 TNFi, of which 1,977 were adalimumab) were included. The proportions of patients treated with secukinumab during the first, second, and third-plus lines of treatment were 1%, 6%, and 22%, respectively). Extraarticular manifestations varied across treatments, while other baseline characteristics were largely similar. Secukinumab had a 1-year retention comparable to adalimumab as a first or second line of treatment but poorer as a third-plus line of therapy (secukinumab 56% [95% confidence interval (95% CI) 51–61%] versus adalimumab 70% [95% CI 64–75%]; HR adj 1.43 [95% CI 1.12–1.81]). Across treatment lines, secukinumab had poorer estimates for 6-month response rates than adalimumab, statistically significantly only for the third-plus line (adjusted analyses: ASDAS score <2.1 OR 0.56 [95% CI 0.35–0.90]; BASDAI <40 mm OR 0.62 [95% CI 0.41–0.95]). Treatment outcomes varied across the 5 TNFi. Conclusion: Secukinumab was mainly used in biologics-experienced patients with SpA. Secukinumab and adalimumab performed similarly in patients who had failed a first biologic, although with increasing prior biologic exposure, adalimumab was superior.

Original languageEnglish
Pages (from-to)748-758
Number of pages11
JournalArthritis and Rheumatism
Volume74
Issue number5
DOIs
Publication statusPublished - May 2022

Bibliographical note

Funding Information:
The authors acknowledge patients and colleagues who contribute data to the DANBIO, SRQ, ROB-FIN, NOR-DMARD, and ICEBIO registries.

Funding Information:
Dr. Glintborg has received research support from AbbVie, Pfizer, and Bristol Myers Squibb. Dr. Provan has received consulting fees from Novartis (less than $10,000). Dr. Gudbjornsson has received speaking fees from Amgen and Novartis (less than $10,000 each). Dr. Hetland has received consulting fees and/or speaking fees from Eli Lilly and Company, Orion Pharma, Biogen, Pfizer, CellTrion, Merck, and Samsung Bioepis (less than $10,000 each) and research support from Bristol Myers Squibb, MSD, AbbVie, Roche, Novartis, Biogen, and Pfizer. Dr. Michelsen has received consulting fees from Novartis (less than $10,000) and research support from Novartis. Dr. Wallman has received consulting fees from Celgene, Eli Lilly and Company, and Novartis (less than $10,000 each). Dr. Hokkanen has received research support from MSD. Dr. Nordström has received consulting fees from AbbVie, Bristol Myers Squibb, Eli Lilly and Company, MSD, Novartis, Pfizer, Roche, and UCB (less than $10,000 each). Dr. Jørgensen has received speaking fees from AbbVie, Pfizer, Roche, Novartis, UCB, Biogen, and Eli Lilly and Company (less than $10,000 each). Dr. Grøn has received research support from Bristol Myers Squibb. Dr. Kristensen has received speaking fees from Pfizer, AbbVie, Amgen, UCB, Sanofi, Gilead, Bristol Myers Squibb, Biogen, MSD, Novartis, Eli Lilly and Company, and Janssen Pharmaceuticals (less than $10,000 each). Dr. Jacobsson has received consulting fees, speaking fees, and/or honoraria from Pfizer, AbbVie, Novartis, Eli Lilly and Company, and Janssen (less than $10,000 each). No other disclosures relevant to this article were reported.

Publisher Copyright:
© 2020 American College of Rheumatology.

Other keywords

  • Adalimumab/therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Biological Products/adverse effects
  • Humans
  • Prospective Studies
  • Registries
  • Spondylarthritis/diagnosis
  • Spondylitis, Ankylosing/drug therapy
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors/therapeutic use

Fingerprint

Dive into the research topics of 'One-Year Treatment Outcomes of Secukinumab Versus Tumor Necrosis Factor Inhibitors in Spondyloarthritis: Results From Five Nordic Biologic Registries Including More Than 10,000 Treatment Courses'. Together they form a unique fingerprint.

Cite this