Pharmacy Department, Hospital General Universitario Santa Lucía, Cartagena (Murcia). Spain.
Farm Hosp. 2020 Dec 31;45(1):16-21. doi: 10.7399/fh.11465.
To determine persistence of treatment with secukinumab across its different indications.
This is a retrospective descriptive observational study including adult patients treated with secukinumab in its different indications from the drug's introduction in November 2015 to October 2019. The variables included were sex; age; diagnosis; initiation date; line of treatment; number of patients who discontinued treatment and reason for discontinuation; overall persistence at 12 months; distribution of patients; and persistence according to indication, line of treatment and reason for suspension.
One-hundred forty-three patients were started on secukinumab, but only patients who had been in treatment at least 12 months before the end of the study were included. Mean patient age was 49.8 years (±12.6); 52.9% were men. Fifty-six patients (53.8%) had discontinued treatment by the end of the study, with a mean duration of treatment of 12.7 months (±10.2). The other patients (n = 48) continued with their therapy. Mean duration of treatment in these patients was 25.7 months (±9.9). Overall persistence at 12 months was 10.0 months (±3.3) with a discontinuation rate at 12 months of 31.7%. Persistence at 12 months was 10.7 months (±2.9) for patients with psoriasis, 9.7 months (±3.4) for patients with psoriatic arthritis, and 8.8 months (±3.8) for those with ankylosing spondylitis. Of the 48 patients who continued with their treatment after completion of the study, 22 (45.8%) received the drug as first-line treatment. Of the 56 discontinuations, 15 (26.8%) were due to primary failure (persistence: 3.8 months [±1.1]) and 27 (48.2%) were due to secondary failure (persistence: 18.6 months [±9.6]). Persistence in patients who continued treatment was higher in psoriasis (28.8 months [±10.3]). In those who discontinued due to secondary failure it was higher in the group with ankylosing spondylitis (28.0 months [±4.2]). Persistence among patients on first-line secukinumab was higher than for other patients: 21.2 months (±7.2) if they stayed on treatment, 3.5 months (±0.5) if they presented with primary treatment failure, and 8.3 months (±2.5) in those with secondary treatment failure.
Our data show slightly higher persistence levels in patients with psoriasis and lower discontinuation rates in those without previous exposure to biological therapy. Long-term studies are needed to confirm these findings and to gain a better understanding of the factors that can influence persistence of secukinumab.
确定司库奇尤单抗在不同适应证中的治疗持续性。
这是一项回顾性描述性观察研究，纳入了自 2015 年 11 月司库奇尤单抗上市至 2019 年 10 月在不同适应证中接受治疗的成年患者。纳入的变量包括性别；年龄；诊断；起始日期；治疗线数；停止治疗的患者人数和停药原因；12 个月时的总体持续性；患者分布；以及根据适应证、治疗线数和停药原因的持续性。
共有 143 例患者开始使用司库奇尤单抗，但仅纳入了在研究结束前至少接受 12 个月治疗的患者。患者平均年龄为 49.8 岁（±12.6）；52.9%为男性。56 例患者（53.8%）在研究结束时停止治疗，平均治疗持续时间为 12.7 个月（±10.2）。其余患者（n=48）继续接受治疗。这些患者的平均治疗持续时间为 25.7 个月（±9.9）。12 个月时的总体持续性为 10.0 个月（±3.3），12 个月时的停药率为 31.7%。银屑病患者的 12 个月持续性为 10.7 个月（±2.9），银屑病关节炎患者为 9.7 个月（±3.4），强直性脊柱炎患者为 8.8 个月（±3.8）。在完成研究后继续接受治疗的 48 例患者中，有 22 例（45.8%）作为一线治疗药物。在 56 例停药患者中，15 例（26.8%）因原发性失败（持续性：3.8 个月[±1.1]），27 例（48.2%）因继发性失败（持续性：18.6 个月[±9.6]）。继续治疗的患者中，银屑病患者的持续性较高（28.8 个月[±10.3]）。继发性失败的患者中，强直性脊柱炎组的持续性较高（28.0 个月[±4.2]）。作为一线司库奇尤单抗治疗的患者，其持续性高于其他患者：继续治疗者为 21.2 个月（±7.2），原发性治疗失败者为 3.5 个月（±0.5），继发性治疗失败者为 8.3 个月（±2.5）。
我们的数据显示，银屑病患者的持续性略高，且既往未接受过生物治疗的患者停药率较低。需要进行长期研究以证实这些发现，并深入了解影响司库奇尤单抗持续性的因素。
