{
  "abstract": "Background and Importance Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting joints and skin, impacting patient-reported outcomes. Secukinumab, an anti-IL-17A antibody, has demonstrated efficacy, although response and persistence may vary by treatment line, as shown in several studies. Understanding the influence of biologic sequencing is important for optimising patient management.Aim and Objectives To evaluate differences in the effectiveness and persistence of secukinumab according to prior biologic exposure (naïve vs previously treated) and initial dosage.Material and Methods A retrospective, observational study (January 2017-February 2025) was conducted including all PsA patients treated with secukinumab monotherapy.Data were collected from electronic records and the pharmacy program, including the secukinumab treatment line (first-line to fourth-line), start/end dates, initial dosage, and prior biological treatments. One patient was excluded for missing data.Effectiveness was assessed at 24 weeks, classifying patients as responders (clinical improvement) or non-responders (worsening), based on physician documentation. Persistence was estimated with Kaplan–Meier, defined as months from treatment initiation to discontinuation for any reason; patients still on treatment were censored. Differences in persistence by initial dosage (150 mg vs 300 mg every 4 weeks) and treatment line were compared using log-rank test. Statistical analysis was performed with R (v4.4.1).Results Of the 61 patients, 6.6% received secukinumab as first-line therapy, 57.4% as second-line, 31.1% as third-line, and 4.9% as fourth-line. Overall, 74% achieved a clinical response at 24 weeks: 100% in first-line, 83% in second-line, 58% in third-line, and 3.3% in fourth-line.The median overall persistence was 36.4 months (95% CI:20.3–NA); in naïve patients, 36.8 months (range 10.5–53). No statistically significant differences in persistence were observed (95% CI:0.69–1.91; p=0.59) among patients previously exposed to one (40 months, range 1.5–98), two (27.7 months, range 0.9–93), or three biologics (31 months, range 4–31).The 300 mg every 4 weeks regimen showed a trend towards higher persistence versus 150 mg (HR=0.76), although this was not statistically significant (95% CI: 0.4–1.5; p=0.44).Conclusion and Relevance Secukinumab showed high overall effectiveness (74% response rate).Treatment-naïve patients had better outcomes, declining in later lines.Treatment line and initial dose did not significantly affect persistence.The position of secukinumab within the therapeutic sequence may be related to these outcomes, although larger prospective studies are needed to confirm this finding.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "M Muñoz Villasur"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "C Rodríguez-Tenreiro Rodríguez"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "V Garcia Jimenez"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "C Fadón Herrera"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "C Díaz Romero"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "I Maray Mateos"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "AM Gómez Mato"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "M Latasa Berasategui"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "C Esparrago Fernandez"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "M Varela Ferreiro"
    },
    {
      "affiliations": [
        "Hospital Universitario Central De Asturias, Hospital Pharmacy, Oviedo, Spain"
      ],
      "name": "A Lozano Blázquez"
    }
  ],
  "title": "4CPS-061 Effectiveness and persistence of secukinumab in psoriatic arthritis: comparison between biologic-naïve and previously treated patients",
  "uid": "8ac62661-13e7-597a-8275-7f9bcd463017"
}