(P-096) Comparative Clinical Effectiveness of Secuquinumabe and Anti-tnf Agents in the Treatment of Psoriasic Arthritis

Background: Psoriatic arthritis (PA) is a chronic, autoimmune inflammatory disease and can result in a decrease in patients’ quality of life.

Objectives: To explore the comparative clinical effectiveness of secuquinumabe and anti-TNF agents in patients diagnosed with PA treated by the Unified Health System (SUS) unit in the Belo Horizonte city, Brazil.

Methods: A prospective cohort was conducted with patients using biological DMARDs for the treatment of PA, from January/ 2012 to December/2020, in Belo Horizonte city. Information about demographic and clinical characteristics, as well as medication use, was collected. Disease activity was assessed using the Ankylosing Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI) instruments, functional capacity by the Health Assessment Questionnaire-Disability Index (HAQ-DI) and quality of life by the EuroQol-5 dimensions (EQ-5D). Patients were followed up for 6 months. Analyses included the t-test.

Results: In total, 245 patients were included, 58.0% were women, 52.2% were white, the average age was 51.5 years and the mean duration of the disease was 6.1 years. 202 patients completed the follow-up, 174 used an anti-TNF (adalimumab, infliximab, etanercept or golimumab) and 28 used secuquinumab. After 6 months, the anti-TNF group showed an average reduction in BASDAI of 5.19 to 3.57, in CDAI of 22.58 to 13.26, in HAQ-DI of 1.19 to 0, 84 and an increase in EQ-5D of 0.65 to 0.74. The secuquinumab group showed an average reduction in BASDAI of 5.37 to 3.75, in CDAI of 25.70 to 16.61, in HAQ-DI of 1.20 to 0.86 and an increase in EQ-5D of 0.61 to 0.69. A statistically significant difference (paired t-test, p <0.05) was observed for the outcomes, when comparing the measurements at the baseline and after 6 months, for both groups. The independent t-test showed no statistically significant difference between anti-TNF and secuquinumab (t-teste, p >0.05), at 6 months of treatment. 58.6% of patients using anti-TNF achieved effectiveness by BASDAI and 54.6% by CDAI. For the group using secuquinumab, 57.1% of patients achieved effectiveness by BASDAI and 39.3% by CDAI.

Conclusions: Biological DMARDs are effective. Patients with psoriatic arthritis displayed better functional capacity and quality of life, with no difference in clinical effectiveness between the anti-TNF and secuquinumab groups.