Persistence of secukinumab in patients with psoriasis, psoriatic arthritis, and ankylosing spondylitis

To determine persistence of treatment with secukinumab across its different indications.

This is a retrospective descriptive observational study including adult patients treated with secukinumab in its different  indications from the drug's introduction in November 2015 to October  2019. The variables included were sex; age; diagnosis; initiation date; line of treatment; number of patients who discontinued treatment and reason  for discontinuation; overall persistence at 12 months; distribution of  patients; and persistence according to indication, line of treatment and  reason for suspension.

One-hundred forty-three patients were started on secukinumab, but only patients who had been in treatment at least 12  months before the end of the study were included. Mean patient age was  49.8 years (±12.6); 52.9% were men. Fifty-six patients (53.8%) had  discontinued treatment by the end of the study, with a mean duration of  treatment of 12.7 months (±10.2). The other patients (n = 48) continued  with their therapy. Mean duration of treatment in these patients was 25.7  months (±9.9). Overall persistence at 12 months was 10.0 months (±3.3)  with a discontinuation rate at 12 months of 31.7%. Persistence at 12  months was 10.7 months (±2.9) for patients with psoriasis, 9.7 months  (±3.4) for patients with psoriatic arthritis, and 8.8 months (±3.8) for  those with ankylosing spondylitis. Of the 48 patients who continued with  their treatment after completion of the study, 22 (45.8%) received the  drug as first-line treatment. Of the 56 discontinuations, 15 (26.8%) were  due to primary failure (persistence:  3.8 months [±1.1]) and 27 (48.2%)  were due to secondary failure (persistence: 18.6 months [±9.6]).  Persistence in patients who continued treatment was higher in psoriasis  (28.8 months [±10.3]). In those who discontinued due to secondary  failure it was higher in the group with ankylosing spondylitis (28.0 months  [±4.2]). Persistence among patients on first-line secukinumab was higher  than for other patients: 21.2 months (±7.2) if they stayed on treatment,  3.5 months (±0.5) if they presented with primary treatment failure, and  8.3 months (±2.5) in those with secondary treatment failure.

Our data show slightly higher persistence levels in patients with psoriasis and lower discontinuation rates in those without  previous exposure to biological therapy. Long-term studies are needed to  confirm these findings and to gain a better understanding of the factors  that can influence persistence of secukinumab.