Real-World Effectiveness and Safety of Secukinumab in Giant Cell Arteritis: An Italian Multicenter Cohort Study

The objective of this study was to evaluate the real-world effectiveness and safety of secukinumab in patients with giant cell arteritis (GCA).

This multicenter retrospective study included patients with GCA who received secukinumab at 14 Italian centers with at least six months of follow-up. Outcomes included clinical, complete, and glucocorticoid (GC)-free remission, GC dose reduction, drug retention rate, and adverse events.

Thirty-six patients were included (66.7% women); median age at secukinumab initiation was 74 (interquartile range [IQR] 70-80) years. Overall, 32 of 36 patients (88.9%) had previously relapsed and 26 of 36 (72.2%) had received tocilizumab. Clinical remission was observed in 85.2%, 80.6%, and 83.3% at 3, 6, and 12 months, respectively. Complete remission occurred in 55.6%, 52.8%, and 63.3%, whereas GC-free remission increased progressively, reaching 14.8%, 27.8%, and 40.0% at 3, 6, and 12 months, respectively (P = 0.012). Median daily GC dose decreased from 8.7 (IQR 4.0-21.2) mg at baseline to 0 (0-5.0) mg at 12 months (P < 0.001); GCs were discontinued in 12 of 28 patients (42.9%). The 12-month retention rate was 77.0%. Adverse events occurred in 20 of 36 patients (55.6%); infections occurred in 18 of 36 patients (50.0%), accounting for 21 infectious episodes.

In this multicenter, real-world cohort of patients with GCA, including those with relapsing disease and previous biologic exposure, secukinumab was associated with high observed remission rates, progressive GC dose reduction, and increasing GC-free remission. Although the phase III GCAptAIN trial did not meet its primary endpoint, these findings suggest that interleukin-17A inhibition may warrant further evaluation in patients with GCA.