Impact of the time of initiation and line of biologic therapy on the retention rate of secukinumab in axial spondyloarthritis (axSpA): data from the French multicentre retrospective FORSYA study.

To compare the 1-year retention rate of secukinumab in axial spondyloarthritis (axSpA) and its predisposing factors with regard to its time of initiation (eg, right after or remotely from its launch). Study design: Retrospective multicentre French study of patients with axSpA. Study periods: Two cohorts were evaluated regarding the time of initiation of secukinumab: cohort 1 (C1)-between 16 August 2016 and 31 August 2018-and cohort 2 (C2)-between 1 September 2018 and 13 November 2020. The 1-year retention rate of secukinumab was estimated using the Kaplan-Meier method, and the log-rank test was used to compare the retention curves of the two cohorts. Preselected factors (eg, disease characterristics, line and time of secukinumab initiation) of secukinumab retention at 1 year were analysed by univariate and multivariate Cox model regression. In total, 906 patients in C1 and 758 in C2 from 50 centres were included in the analysis. The 1-year retention rate was better in C2 (64% (61%-68%)) vs C1 (59% (55%-62%)) (HR=1.19 (1.02-1.39); p=0.0297). In the multivariate analysis, the line of biologic therapy was the single predictive factor of the 1-year retention rate of secukinumab picked up in both cohorts, with a better retention rate when prescribed as first-line biologic therapy. The better secukinumab retention rate remotely from its launch is explained by its use at an earlier stage of the disease, suggesting a change in the behaviour of prescribing physicians. Our results emphasise the relevance of iterative evaluations of routine care treatments.

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Competing interests: MD: grant/research support from AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma; consultant of AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma; speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma. ALC: employee of RCTs, a CRO provider on behalf of Novartis Pharma. ED: employee of Novartis with stocks. PC: research grants, consultant and speaker fees from AbbVie, Bristol Myers Squibb, Janssen, Lilly, Merck Sharp & Dohme, Novartis, Pfizer and UCB. PG: research grants, consultation fees or speaker honoraria from AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB. ARW: consulting (Pfizer, AbbVie, Novartis, Lilly and Janssen); honoraria (AbbVie, Bristol-Myers Squibb, Galapagos, Fresenius-Kabi, Mylan-Viatris, MSD, Novartis, Lilly, UCB, Pfizer, Roche-Chugai and Sanofi) and support for attending meetings (Abbvie, Amgen and Fresenius-Kabi). AS: research grants, consultant fees and speaker fees from AbbVie, Bristol Myers Squibb, Lilly, MSD, Nordic, Novartis, Pfizer, Roche-Chugai and UCB. AT: research grants, consultant fees and speaker fees from AbbVie, Fresenius-Kabi, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai and Sanofi. DW: financial interests: none; lasting or permanent links: none; occasional interventions: AbbVie, BMS, MSD, Pfizer, Roche Chugai, Amgen, Nordic Pharma, UCB, Novartis, Lilly, Sandoz and galapagos; and indirect interests: AbbVie, Pfizer, MSD, UCB, galapagos and Fresenius Kabi. CL: research grants, consultant fees and speaker fees from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Fresenius, Janssen, Lilly, MSD, Novartis, Pfizer, Roche Chugai and UCB.