A comparison of apremilast monotherapy and combination therapy for psoriatic arthritis in a real-life setting: Data from the Leeds Combined Psoriatic Service

Background:In early rheumatoid arthritis (ERA) a window of opportunity (WoO) is well established since its first proposal in 2002 (1). ERA patients achieved a better clinical outcome when DMARD therapy was initiated within the first 12-16 weeks after start of symptoms (disease duration (Xd) (2). To the best of our knowledge, comparable data are missing for early psoriatic arthritis (EPsA), even though the benefit of tight control is known in EPsA (3,4). In contrast to ERA early PsA is usually defined as Xd <24months (3,4).Objectives:To study in a setting of routine rheumatologic care if a WoO like in ERA also can be observed in EPsA comparable to ERA.Methods:n=90 consecutive outpatients with definite PsA were recruited in this retrospective longitudinal cohort study with the following inclusion criteria: DMARD- and steroid-naïve at the first time of visit in our outpatient clinic (t0), minimum follow-up of 3 years, classification as very early psoriatic arthritis (VEPsA, Xd≤3 months, n=30), late early psoriatic arthritis (LEPsA, > 3 Xd ≤ 12 months, n=30) and late psoriatic arthritis (LAPsA, Xd > 36 months, n=30). Standardized assessments had been performed at regular intervals of 3 months within the framework of routine rheumatologic care. Outcome at 3 years (t36) was analyzed within groups and between groups (DAS28, Physician Global Assessment (PhG), HAQ, fatigue, morning stiffness).Results:Cohorts did not differ between gender and age (mean age 54 years). There was no significant difference in DAS28, HAQ, PhG and morning stiffness at t0. Fatigue at t0 differed between cohort 1 and 3 significantly (p<0.03). In all cohorts DAS28 and PhG have been decreased at t36 significantly (minimal p< 0.006). In comparison to VEPsA LEPsA showed a significant difference in DAS28 (p<0.04) and PhG (p<0.05), but not in morning stiffness and fatigue. Highly significant differences between VEPsA and LAPsA were observed for DAS28 (p <0.007), morning stiffness (p < 0.001), PhG (p<0.05) and fatigue (p < 0.006) at t36.Conclusion:Significant and relevant differences between the outcomes at 3 years of patients with VEPsA, LEPsA and LAPsA could be identified in this retrospective pilot study. Particularly the highly significant difference between VEPsA and LAPsA (<3 months vs. >36months) is remarkable. The data suggest a window of opportunity also in patients with EPsA. With a time interval of Xd≤12 this window seems to be longer than in ERA. Further studies with higher number of patients were needed to confirm our findings from this real life setting.References:[1]O´Dell JR Treating Rheumatoid Arthritis Early: A Window of Opportunity? Arthritis Rheum 2002;46:283–285[2]Nell VPK, Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS Rheumatology 2004 43:906-914[3]Coates LC, Moverley AR, McParland Let al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial.Lancet2015,386:2489–98.[4]Coates LC, Mahmood F, Freeston J, Emery P, Conaghan PG, Helliwell PS Long-term follow-up of patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial Rheumatology (Oxford) 2019 kez369Disclosure of Interests:None declared

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FRI0273 EFFECTIVENESS AND RETENTION RATE OF SECUKINUMAB FOR PSORIATIC ARTHRITIS AND AXIAL SPONDYLOARTHRITIS: REAL-LIFE DATA FROM THE ITALIAN LORHEN REGISTRY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3197 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 722.1-723

Author(s):

E. G. Favalli ◽

A. Marchesoni ◽

S. Balduzzi ◽

C. Montecucco ◽

C. Lomater ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Axial Spondyloarthritis ◽

Retention Rate ◽

Real Life ◽

Advisory Board ◽

Inactive Disease ◽

Real Life Setting

Background:Observational data on the use of secukinumab for the treatment of spondyloarthritides are still lacking. Large population-based registries that allow long-term follow-up have been increasingly used to investigate the performance of biologic drugs in a real life setting.Objectives:The aim of this study is to evaluate the effectiveness and the retention rate of secukinumab in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients in a real-life setting over a 3-year follow-up period.Methods:Data of all PsA and axSpA patients (diagnosed according to CASPAR and ASAS criteria, respectively) treated with secukinumab were prospectively collected in the Italian multicentric LORHEN registry. Effectiveness was measured as the mean change from baseline of Disease Activity in PSoriatic Arthritis score (DAPSA) in PsA and Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA patients. Rates of DAPSA remission and ASDAS inactive disease were also computed. The 3-year retention rate was calculated by the Kaplan-Meier method and compared between PsA and axSpA by a log-rank test. A descriptive analysis of reasons for discontinuation was performed.Results:The study population included 195 PsA (55.4% females, mean age 50.7 [±11.8] years, mean disease duration 10 [±7.8] years, mean baseline DAPSA 23.12 [±12.3]) and 94 axSpA (61.7% males, mean age 49.1 [±12.7] years, mean disease duration 10.4 [±9.4] years, mean baseline ASDAS 3.41 [±1.1]) patients who received secukinumab as first (26.5 and 33%, respectively) or subsequent biologic agent. Compared with baseline, the 3-, 6- and 12-month mean values of both DAPSA (12.6 [±9], 11.2 [±10.5] and 9.3 [±7.5], respectively) and ASDAS (2.23 [±0.9], 2.15 [±0.9], and 1.84 [±0.9], respectively) were significantly decreased (p<0.001 for all the timepoints). The 3-, 6-, and 12-month rates of remission/inactive disease were 15.5, 25.4, and 30.5% in PsA and 18, 23.7, and 28.6% in axSpA group, respectively. One- and 3-year retention rate (figure 1) were respectively 79.4% and 66.6% in PsA and 72.3% and 70.1% in axSpA patients, with no significant difference between the two groups (p=0.517). The most frequent reason for withdrawal was inefficacy in both PsA (n=41) and axSpA (n=20), whereas only 8 PsA and 6 axSpA patients discontinued secukinumab because of adverse events.Conclusion:Our data confirmed in a real-life setting the 1-year clinical efficacy and the 3-year survival of secukinumab in both PsA and axSpA. The safety profile of secukinumab was very favorable for both the indications. No significant differences were observed in the performance of secukinumab between ax-SpA and PsA.References:[1]Deodhar A, et al. Arthritis Research & Therapy; 2019.[2]Mease PJ, et al. RMD Open. BMJ Specialist Journals; 2018;4(2):e000723.[3]Baraliakos X, et al. Clin Exp Rheumatol. 2018 Jan;36(1):50–5.Disclosure of Interests:Ennio Giulio Favalli Consultant of: Consultant and/or speaker for BMS, Eli-Lilly, MSD, UCB, Pfizer, Sanofi-Genzyme, Novartis, and Abbvie, Speakers bureau: Consultant and/or speaker for BMS, Eli-Lilly, MSD, UCB, Pfizer, Sanofi-Genzyme, Novartis, and Abbvie, Antonio Marchesoni Speakers bureau: Abbvie, Pfizer, UCB, Novartis, Celgene, Eli Lilly, Silvia Balduzzi: None declared, Carlomaurizio Montecucco: None declared, Claudia Lomater Consultant of: Advisory board for Sanofi, Novartis, Abbvie, Gloria Crepaldi Consultant of: Advisory board for Sanofi and Celgene, Speakers bureau: BMS, MSD, Silvia Talamini: None declared, Chiara Bazzani: None declared, Enrico Fusaro: None declared, Marta Priora: None declared, Aurora Iannello: None declared, Giuseppe Paolazzi: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

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SAT0307 Impact of the modified rheumatic disease comorbidity index(MRDCI) on drug survival of first line anti-tnfΑ drugs in patents affected with psoriatic arthritis in real life setting

10.1136/annrheumdis-2018-eular.2216 ◽

2018 ◽

Author(s):

M. Fornaro ◽

V. Venerito ◽

L. Cantarini ◽

M.G. Anelli ◽

F. Cacciapaglia ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Rheumatic Disease ◽

Real Life ◽

First Line ◽

Drug Survival ◽

Real Life Setting ◽

Comorbidity Index

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Long-term effectiveness and drug survival of golimumab in patients affected by psoriatic arthritis with cutaneous involvement

Clinical Rheumatology ◽

10.1007/s10067-021-05874-6 ◽

2021 ◽

Author(s):

Maria Sole Chimenti ◽

Paola Conigliaro ◽

Francesco Caso ◽

Luisa Costa ◽

Augusta Ortolan ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Smoking Habit ◽

Survival Rates ◽

Real Life ◽

Wilcoxon Test ◽

Cutaneous Manifestations ◽

Drug Survival ◽

Real Life Setting ◽

Insufficient Response

Abstract Objectives To determine the effectiveness of golimumab (GLM) in improving joint, periarticular structures and cutaneous manifestations in patients with moderate to severe psoriatic arthritis (PsA) with cutaneous psoriasis in different real-life clinical settings and 48-month drug survival. Methods Clinical and laboratory records were collected from PsA patients treated with GLM at baseline (T0) and after 6, 12, 24, 36, and 48 months of treatment. Comparisons were performed using a paired t-test or Wilcoxon test. Drug survival rates were analyzed using Kaplan–Meier estimates. p value < 0.05 was considered statistically significant. Results Data from 105 patients were collected. PsO occurred in 80% of patients and enthesitis in 78%, peripheral and axial arthritis in 63.8% and 35.3%, respectively, while erosions in 36.2%. The main comorbidities were cardiovascular diseases (31.4%) and metabolic syndrome (MetS) (19%). A statistically significant improvement in articular and cutaneous psoriasis was registered at T48 of GLM-therapy in clinical (DAPSA p < 0.0001; PASI p < 0.01; BASDAI p < 0.0001) and laboratory (CRP < 0.05) indexes. Gender (p = 0.652), BMI (p = 0.655), smoking habit (p = 0.466), and line of treatment (p = 0.208) did not affect treatment efficacy nor persistence. At T48, 42% of patients discontinued GLM: the most frequent reason was an insufficient response or loss of efficacy (28.6%). Conclusion A 48-month GLM high drug persistence of PsA patients was observed in real-life, in patients presenting high disease activity, elevated prevalence of comorbidities, and more than one line of treatment at baseline. Patients’ characteristics as gender, smoke, BMI, different lines of treatment, and concomitant methotrexate treatment affected treatment persistence, making GLM effective and safe in moderate-severe PsA in a long-term real-life setting. Key Points• Golimumab was effective in psoriatic arthritis, including both musculoskeletal and cutaneous manifestations. • Golimumab effectiveness and drug survival were not affected by comorbidities and patient-related characteristics. • The 4-year drug survival curves confirm the efficacy and safety of golimumab in psoriatic arthritis patients in a real-life setting.

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Long-Term Retention Rate of Golimumab in Patients With Rheumatoid Arthritis, Psoriatic Arthritis, and Spondyloarthritis in a Real-Life Setting

JCR Journal of Clinical Rheumatology ◽

10.1097/rhu.0000000000001695 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Belén Serrano-Benavente ◽

Larissa Valor ◽

Tamara del Río Blasco ◽

Iustina Janta ◽

Roberto González Benítez ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Psoriatic Arthritis ◽

Retention Rate ◽

Real Life ◽

Term Retention ◽

Real Life Setting ◽

Long Term Retention

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FRI0270 ONE-YEAR EFFECTIVENESS, RETENTION RATE AND SAFETY OF SECUKINUMAB IN ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS: A REAL-LIFE MULTICENTRE STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3777 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 720-720

Author(s):

M. S. Chimenti ◽

G. L. Fonti ◽

P. Conigliaro ◽

F. Sunzini ◽

R. Scrivo ◽

...

Keyword(s):

Metabolic Syndrome ◽

Psoriatic Arthritis ◽

Ankylosing Spondylitis ◽

Retention Rate ◽

Survival Curve ◽

Diagnostic Delay ◽

Real Life ◽

Joint Involvement ◽

Real Life Setting ◽

Patient Reported

Background:Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomised trials, but real-life data are lacking.Objectives:In this prospective observational study, we evaluated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting.Methods:From September 2018 to September 2019, data were collected from 168 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 129 PsA, 77%).Results:Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes such as VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R2=0.4; p=0.009) and peripheral joint involvement (R2=0.4; p=0.04). During follow-up, reduction of BASDAI positively correlated with high ESR (R2=0.65; p=0.04). ASDAS-CRP at T0 positively correlated with high ESR (R2=0.34; p=0.004). Reduction of ASDAS-CRP from T0 to T6 correlated with current smoking status (R2=0.42; p=0.0005). In PsA patients, reduction of DAPSA score from T0 to T12 negatively correlated with the presence of metabolic syndrome (R2=0.41; p= 0.0025). Retention rate showed good drug survival and an influence of female sex (Figure 1) in the survival curve in only AS patients, but no differences based on BMI, gender and lines of treatment were observed (Figure 2). SEC was well tolerated: Eleven patients discontinued treatment for non-severe adverse events.Conclusion:We demonstrated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting for the first time. No gender differences were observed; however, less clinical improvement was seen in smokers and in patients with metabolic syndromeReferences:No references.Disclosure of Interests:Maria Sole Chimenti: None declared, giulia lavinia fonti: None declared, Paola Conigliaro: None declared, flavia sunzini: None declared, Rossana Scrivo: None declared, luca navarini: None declared, paola triggianese: None declared, giusy peluso: None declared, Palma Scolieri: None declared, rosalba caccavale: None declared, Andrea Picchianti-Diamanti: None declared, erica de martino: None declared, simonetta salemi: None declared, domenico birra: None declared, Alessio Altobelli: None declared, marino paroli: None declared, Vincenzo Bruzzese: None declared, Bruno Laganà: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi, Antonella Afeltra: None declared, Roberto Perricone: None declared

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