OBJECTIVES: In axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating secukinumab, we aimed to assess retention rates and proportions of patients achieving remission and low disease activity (LDA), according to disease activity measures and patient-reported outcomes at 24 and 48 months. PATIENTS AND METHODS: Data on patients with axSpA and PsA who initiated secukinumab treatment were pooled from 13 European registries. Analyses were performed overall and stratified according to the number of previous biologic/targeted synthetic Disease-Modifying Antirheumatic Drugs (b/tsDMARDs, 0/1/≥2). Kaplan-Meier plots and Cox regression analyses were performed to assess and compare secukinumab retention rates. Comparisons of remission and LDA rates were performed by logistic regression analyses. RESULTS: The overall 24-/48-month secukinumab retention rates were 61%/51% in 767 axSpA patients, and 64%/49% in 975 PsA patients, respectively. Compared to b/tsDMARD naïve patients, a higher risk of withdrawal from secukinumab was found for those with≥2 prior b/tsDMARDs in axSpA and PsA, and 1 prior b/tsDMARD in axSpA. Generally, remission and LDA rates were numerically higher in b/tsDMARD naïve patients. After adjustment for confounders, statistically significantly higher remission and LDA rates were found for b/tsDMARD naïve patients compared to patients with≥ 2 prior b/tsDMARDs at 24 months in axSpA and PsA. CONCLUSION: This large European real-world study demonstrates that 4-year secukinumab retention rates were approximately 50% in both axSpA and PsA. b/tsDMARD naïve patients had higher retention, remission and LDA rates than patients with prior b/tsDMARD exposure.

Aberdeen Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK

Center for Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania

Centre for Rheumatology Research Landspitali University Hospital Reykjavik Iceland; Faculty of Medicine University of Iceland Reykjavik Iceland

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

Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Centre for Head and Orthopedics Rigshospitalet Glostrup Denmark; Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Copenhagen Center for Arthritis Research Diakonhjemmet Hospital Oslo Norway; Research Unit Sørlandet Hospital Kristiansand Norway

Copenhagen Center for Arthritis Research Glostrup Denmark; Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Department of Clinical Sciences Lund Rheumatology Skåne University Hospital Lund University Lund Sweden

Department of Medicine Faculty of Medicine University of Porto Rheumatology Department Centro Hospitalar e Universitário de São João Porto Portugal

Department of Rheumatology Aarhus University Hospital Aarhus Denmark; Department of Clinical Medicine Aarhus University Aarhus Denmark

Department of Rheumatology East Tallinn Central Hospital Tallinn Estonia

Department of Rheumatology Geneva University Hospital Geneva Switzerland

Department of Rheumatology Hospital General Universitario Gregorio Marañón Madrid Spain; Faculty of Medicine Complutense University of Madrid Madrid Spain

Department of Rheumatology Unidade Local de Saúde Santa Maria Lisbon Portugal; Rheumatology Research Unit Instituto de Medicina Molecular Faculdade de Medicina Universidade de Lisboa Lisbon Academic Medical Centre Lisbon Portugal

Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland

Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia; Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Departments of Medicine and Rheumatology Helsinki University Hospital Helsinki Finland

Division of Rheumatology Department of Internal Medicine Dokuz Eylul University School of Medicine Izmir Turkey

Faculty of Medicine University of Iceland Reykjavik Iceland; Department of Clinical Sciences Lund Rheumatology Skåne University Hospital Lund University Lund Sweden

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

National Institute for Health Development Tallinn Estonia

Research Unit Spanish Society of Rheumatology Madrid Spain

Rheumatology Radboud University Medical Center Nijmegen Netherlands

Rheumatology Unit DiMePReJ University of Bari Bari Italy

Section for Rheumatology Department for Neurology Rheumatology and Physical Medicine Helse Førde Førde Norway

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