FRI0270 ONE-YEAR EFFECTIVENESS, RETENTION RATE AND SAFETY OF SECUKINUMAB IN ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS: A REAL-LIFE MULTICENTRE STUDY

Background:

Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomised trials, but real-life data are lacking.

Objectives:

In this prospective observational study, we evaluated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting.

Methods:

From September 2018 to September 2019, data were collected from 168 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 129 PsA, 77%).

Results:

Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes such as VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R2=0.4; p=0.009) and peripheral joint involvement (R2=0.4; p=0.04). During follow-up, reduction of BASDAI positively correlated with high ESR (R2=0.65; p=0.04). ASDAS-CRP at T0 positively correlated with high ESR (R2=0.34; p=0.004). Reduction of ASDAS-CRP from T0 to T6 correlated with current smoking status (R2=0.42; p=0.0005). In PsA patients, reduction of DAPSA score from T0 to T12 negatively correlated with the presence of metabolic syndrome (R2=0.41; p= 0.0025). Retention rate showed good drug survival and an influence of female sex (Figure 1) in the survival curve in only AS patients, but no differences based on BMI, gender and lines of treatment were observed (Figure 2). SEC was well tolerated: Eleven patients discontinued treatment for non-severe adverse events.

Conclusion:

We demonstrated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting for the first time. No gender differences were observed; however, less clinical improvement was seen in smokers and in patients with metabolic syndrome

References:

No references.

Disclosure of Interests:

Maria Sole Chimenti: None declared, giulia lavinia fonti: None declared, Paola Conigliaro: None declared, flavia sunzini: None declared, Rossana Scrivo: None declared, luca navarini: None declared, paola triggianese: None declared, giusy peluso: None declared, Palma Scolieri: None declared, rosalba caccavale: None declared, Andrea Picchianti-Diamanti: None declared, erica de martino: None declared, simonetta salemi: None declared, domenico birra: None declared, Alessio Altobelli: None declared, marino paroli: None declared, Vincenzo Bruzzese: None declared, Bruno Laganà: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi, Antonella Afeltra: None declared, Roberto Perricone: None declared

Clinical and radiological signs of ABPA associated with airways infection with Aspergillus in the absence of specific IgE

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus that mainly affects patients with asthma. For diagnosis, elevated serum IgE level are needed according to Greenberger and Patterson criteria. We report a case of 43 years-old woman who developed ABPA with productive cough, fever and radiological findings of multiple confluent areas of consolidation in both upper lobes. Laboratory tests showed elevated peripheral eosinophil counts (9.3 x 10(3)/ml). In bronchial washing A. galactomannans and A. Fumigatus were isolated, although we found normal levels of serum IgE, and the absence of serum IgG and IgE antibodies to Aspergillus and A. galactomannans. In conclusion, clinical and radiological signs of ABPA can be associated with Aspergillus infection also in the absence of a specific serum antibody reaction.