ACR 2020 | Daily Highlights

Real life effectiveness of secukinumab versus TNF inhibitors

COMPARATIVE EFFECTIVENESS OF SECUKINUMAB, ADALIMUMAB AND OTHER TUMOR NECROSIS FACTOR INHIBITORS USED WITH OR WITHOUT METHOTREXATE IN THE TREATMENT OF PSORIATIC ARTHRITIS

Abstract: 0333
Authors: Denis Choquette et al.

» zum Abstract

Key content:
The EXCEED trial published earlier this year was a double-blind, parallel-group and randomized trial comparing secukinumab (SEC) to adalimumab (ADA) but failed to reach its primary endpoint of showing superiority of SEC versus ADA with regard to achievement of a superior ACR20 at week 52. Registry data from RHUMADATA on 305 patients with PsA was used to compare SEC (n = 118) to ADA (n = 75) and to other TNF inhibitors (n = 112 with the exclusion of etanercept) treated after January 2016. TNF inhibitors were more frequently used in first line (ADA 61.3%, other TNFi 37.5%, SEC 25.4%). Pairwise comparison (SEC vs ADA, ADA vs other TNFi, SEC vs other TNFi) did not show better retention rates for any agent. Pairwise comparison of these agents in monotherapy showed similar retention for SEC and ADA and favoured SEC over other TNFi. Treatment retention was statistically better for patients with concomitant MTX.

Relevance:
Real life data as captured in registries includes patients of different age, previous treatments and comorbidities. This registry dataset from Montreal showed that treatment retention is similar for SEC and ADA or other TNF inhibitors (Golimumab, Certolizumab, Infliximab). In monotherapy, treatment retention was comparable for SEC and ADA, but better with SEC in comparison to the other TNF inhibitors. This implies that treatment retention is better for both SEC and ADA in comparison to other TNFi. Unfortunately we do not have data comparing the retention rates of different drugs in first versus second or third line-leaving the question for the optimal treatment sequence unanswered.

Zusammenfassung und Kommentar von:
Prof. Dr. Andrea Rubbert-Roth
St. Gallen