Real-world retention rate of secukinumab in patients with axial spondyloarthritis: Multi-centric retrospective data from China.

Abstract

Background and objective: Secukinumab (SEC), an interleukin 17A inhibitors (IL-17Ai) has been shown to be effective in managing axial spondyloarthritis (axSpA). However, data on its long-term retention in Chinese populations remain limited. This study aims to evaluate the retention rate of SEC in axSpA and its predisposing factors in Chinese patients.

Methods: We conducted a retrospective cohort study across three centers, including axSpA patients treated with SEC. Prescription records were retrieved from the hospital information system (HIS) and electronic medical records were reviewed to confirm diagnoses and treatment exposures. Retention rates at 12, 24, and 36 months were estimated using Kaplan-Meier analysis. Cox proportional hazards regression assessed the impact of prior biologic therapy and dosage on discontinuation risk. Discontinuation events were also evaluated.

Result: A total of 459 patients were identified and included, with the longest treatment follow-up period reaching 42 months. The overall drug retention rates for SEC were 76.1%, 68.7%, and 62.8% at 12, 24, and 36 months, respectively. Biologics-naïve patients exhibited a higher 12-month retention rate (80.7%) compared to biologic-experienced patients (72.5%). Among biologic-experienced patients, the 12-month retention rates progressively decreased with an increasing number of prior biologics: 74.6% for one prior biologic, 72.0% for two, and 55.3% for three. No statistically significant difference in retention rate was observed between the 300 mg and 150 mg groups (P = 0.334). A total of 82 patients (17.86%) discontinued SEC. The primary reason for discontinuation was switching to alternative therapies (n = 70, 85.4% of discontinuations).

Conclusion: SEC demonstrates robust retention rates in this Chinese axSpA cohort, particularly among biologics-naïve patients.