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Secukinumab showed moderate effectiveness but delayed access and reduced survival in later-line use, especially among publicly insured patients. 

Researchers conducted a retrospective study published in May 2025 issue of Journal of Rheumatology to investigate access, effectiveness, drug survival, and adverse events (AEs) of secukinumab (SEC) in individuals with axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA). 

They assessed patients aged ≥ 18 years with axSpA or axPsA who received ≥ 1 dose of SEC. The interval in days was measured from drug request to first administration. Effectiveness was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score < 4 at 6 months. Drug survival was assessed using Kaplan-Meier curves and Cox regression models. 

The results showed that 117 patients were included, with 72 (61.5%) diagnosed with axPsA and 45 (38.5%) with axSpA. Individuals with public health insurance experienced a longer delay in receiving SEC, with a median wait of 90 days [IQR 60–150], compared to those with social security system coverage (P = 0.01) and private insurance (P = 0.009), SEC effectiveness at 6 months was observed in 72 out of 117 patients (61.5%), including 44 of 72 with axPsA (61.5%) and 28 of 45 with axSpA (62.2%; P = 0.91). The median SEC treatment survival was 48 months [95% CI 32–63]. The SEC used as a third-line or later therapy was linked with reduced survival (hazard ratio 3.43 [95% CI 1.11–11.10]; P = 0.04). The incidence of AEs was 7.9 events per 100 patients per year [95% CI 5–12].  

Investigators concluded that patients with public insurance faced greater delays in receiving SEC and using the drug as a third-line or later therapy significantly reduced its survival despite a low incidence of mild AEs. 

Source: jrheum.org/content/early/2025/06/11/jrheum.2024-1185