SECUKINUMAB (SECU) demonstrates sustained effectiveness and high drug survival rates in patients with moderate-to-severe psoriatic arthritis (PsA), particularly in those with both peripheral and axial involvement, according to real-world data from the Italian Group for the Study of Early Arthritis (GISEA) registry.
PsA is a chronic inflammatory condition that significantly impacts patients’ quality of life. While randomised clinical trials have established the efficacy of SECU, real-world evidence provides valuable insights into its performance in routine clinical practice. This study aimed to evaluate SECU’s effectiveness, drug survival, and predictors of treatment discontinuation in patients with PsA, using data from the GISEA registry.
The study analysed 1,045 patients with PsA, including 783 with peripheral-only PsA (perPsA) and 262 with mixed PsA (peripheral and axial involvement). Drug survival was assessed using Kaplan–Meier analysis, while clinical outcomes such as Disease Activity Index for Psoriatic Arthritis (DAPSA), Psoriasis Area Severity Index (PASI), Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), and Visual Analogue Scale (VAS) pain scores were evaluated at baseline, 6, 12, and 24 months.
SECU survival at 24 months was 63.24%, with significantly higher rates in mixed PsA compared to perPsA (p=0.036). DAPSA scores decreased significantly at 6 months and further improved at 24 months (p<0.0001). Similarly, ASDAS-CRP scores in mixed PsA showed significant reductions at 6 months, remaining stable through 24 months (p<0.0001). VAS pain scores also improved consistently (p<0.0001). Higher age (aHR: 0.98, 95% CI: 0.96–0.99; p=0.007) and lower baseline DAPSA scores (aHR: 1.02, 95% CI: 1.01–1.03; p=0.014) were associated with greater treatment persistence. SECU was well tolerated, with no serious adverse events reported.
These findings underscore SECU’s favourable clinical and safety profile in real-world settings, particularly for patients with mixed PsA. The sustained improvements in disease activity and pain scores over 24 months highlight its potential as a long-term treatment option. Future research should explore predictors of response in diverse patient populations and investigate the impact of SECU on quality of life and functional outcomes. Clinicians should consider these real-world insights when tailoring treatment strategies for patients with PsA, ensuring optimal management of both peripheral and axial disease manifestations.
Katheeja Imani, EMJ
Reference
Lopalco G et al. Efficacy and retention rate of secukinumab in psoriatic arthritis across different clinical phenotypes: insights from the Italian GISEA Registry. Therapeutic Advances in Musculoskeletal Disease. 2025;17.
