OBJECTIVES: To explore 6-month and 12-month secukinumab effectiveness in patients with axial spondyloarthritis (axSpA) overall, as well as across (1) number of previous biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), (2) time since diagnosis and (3) different European registries. METHODS: Real-life data from 13 European registries participating in the European Spondyloarthritis Research Collaboration Network were pooled. Kaplan-Meier with log-rank test, Cox regression, χ² and logistic regression analyses were performed to assess 6-month and 12-month secukinumab retention, inactive disease/low-disease-activity states (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) <2/<4, Ankylosing Spondylitis Disease Activity Score (ASDAS) <1.3/<2.1) and response rates (BASDAI50, Assessment of Spondyloarthritis International Society (ASAS) 20/40, ASDAS clinically important improvement (ASDAS-CII) and ASDAS major improvement (ASDAS-MI)). RESULTS: We included 1860 patients initiating secukinumab as part of routine care. Overall 6-month/12-month secukinumab retention rates were 82%/72%, with significant (p<0.001) differences between the registries (6-month: 70-93%, 12-month: 53-86%) and across number of previous b/tsDMARDs (b/tsDMARD-naïve: 90%/73%, 1 prior b/tsDMARD: 83%/73%, ≥2 prior b/tsDMARDs: 78%/66%). Overall 6-month/12-month BASDAI<4 were observed in 51%/51%, ASDAS<1.3 in 9%/11%, BASDAI50 in 53%/47%, ASAS40 in 28%/22%, ASDAS-CII in 49%/46% and ASDAS-MI in 25%/26% of the patients. All rates differed significantly across number of previous b/tsDMARDs, were numerically higher for b/tsDMARD-naïve patients and varied significantly across registries. Overall, time since diagnosis was not associated with secukinumab effectiveness. CONCLUSIONS: In this study of 1860 patients from 13 European countries, we present the first comprehensive real-life data on effectiveness of secukinumab in patients with axSpA. Overall, secukinumab retention rates after 6 and 12 months of treatment were high. Secukinumab effectiveness was consistently better for bionaïve patients, independent of time since diagnosis and differed across the European countries.

Amsterdam University Medical Centres VU University Medical Centre Department Rheumatology and Immunology Center Amsterdam Netherlands

biorx si and the Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia

Centre for Rheumatology Research University Hospital and Faculty of Medicine University of Iceland Reykjavik Iceland

Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Centre for Head and Orthopedics Rigshospitalet Glostrup Copenhagen Denmark

DANBIO Registry Center for Rheumatology and Spine Diseases Centre for Head and Orthopaedics Rigshospitalet Glostrup Copenhagen Denmark

Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Department of Rheumatology Aarhus University Hospital Aarhus Denmark

Department of Rheumatology and Inflammation Research Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Rheumatology Diakonhjemmet Hospital Oslo Norway

Department of Rheumatology Geneva University Hospital Geneve Switzerland

Department of Rheumatology Izmir Kâtip Çelebi University Izmir Turkey

Department of Rheumatology Landspitali University Hospital Reykjavik Iceland

Department of Rheumatology University Hospital Zurich Zurich Switzerland

Division of Rheumatology Department of Medicine Hospital of Southern Norway Trust Kristiansand Norway

Epidemiology Group School of Medicine Medical Science and Nutrition University of Aberdeen Aberdeen UK

GISEA Registry Rheumatology Unit DETO University of Bari Bari Italy

Institute of Rheumatology and Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

Institute of Rheumatology Prague Czech Republic

Research Unit Spanish Society of Rheumatology Madrid Spain

Reuma pt Registry and Instituto De Medicina Molecular Faculdade De Medicina Universidade De Lisboa Lisboa Lisboa Portugal

Reuma pt registry and Instituto Português de Reumatologia Lisbon Portugal

Rheumatology Service Hospital Clinico Universitario Santiago De Compostela Spain

Rheumatology Unit CHIMOMO Azienda Policlinico of Modena University of Modena Modena Italy

ROB FIN Registry Helsinki University and Helsinki University Hospital Helsinki Finland

TURKBIO Registry Division of Rheumatology Dokuz Eylul University School of Medicine Izmir Turkey

University of Medicine and Pharmacy Carol Davila Bucharest Bucharest Romania

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