Prompt clinical response to secukinumab in patients with axial spondyloarthritis: real-life observational data from three Italian referral centers

Aims: Primary aim of our study was to evaluate short-term efficacy of secukinumab (SCK) in axial spondyloarthritis (axSpA); secondary aims were to identify differences in the clinical and laboratory assessment, according to dosage administered and biologic treatment-lines, and to report any adverse event. Methods: Patients with axSpA consecutively treated with SCK were enrolled. Laboratory assessment was based on erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) evaluation; clinical assessment was performed with the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Data were recorded at baseline and at the 3-month visit. Results: Twenty-one patients (7 males; 14 females) were enrolled; both BASDAI and ASDAS-CRP showed a statistically significant reduction between the baseline and the 3-months visit (p<0.0001 and p=0.0005, respectively). At the laboratory assessment, ESR significantly decreased (p=0.008), while CRP improvement did not reach significance (p=0.213). No statistical significance was observed in BASDAI and ASDAS-CRP improvement (p=0.99 and p=0.69, respectively) and in ESR and CRP variations (p=0.54 and p=0.56, respectively) between patients undergoing SCK 150 mg and subjects administered with SCK 300 mg. No significant differences emerged in the BASDAI, ASDAS-CRP and CRP variations between biologic-naïve patients and subjects previously failing to TNF-α inhibition (p=0.15, p=0.09, p=0.15, respectively). Conversely, ESR decrease was significantly higher in the biologic-naïve subgroup (p=0.01). No adverse events were reported. Conclusions: SCK has proved a remarkable short-term effectiveness regardless the biologic treatment-line, and the dosage of 150 mg confirmed to be appropriate in the clinical and laboratory management of axSpA.