Impact of disease activity outcome measures reporting in the medical records of patients with axial spondyloarthritis on the retention rates of biological treatment: the example of secukinumab use in daily practice in France

Objectives: To estimate the frequency of reporting composite indices evaluating axial spondyloarthritis (axSpA) disease activity in daily practice and to assess its impact on the secukinumab (SEC) retention rate.

Methods: Study design: Retrospective, multicentre.

Data collected: (1) Recommended composite indices: Bath Ankylosing Spondyltitis Disease Activity Index (BASDAI) +C reactive protein or Ankylosing Spondylitis Disease Activity Score (ASDAS) at the time of initiation of SEC and at least once during the first year of follow-up; (2) Drug retention rate: percentage of patients still on SEC over time according to whether at least one recommended composite index had been optimally reported.

Results: A recommended composite index has been collected in 22% of the 906 enrolled axSpA patients. The percentage of patients still on treatment after 1, 2 and 3 years of follow-up was greater in those for whom at least one composite index had been optimally reported (respectively, 64% (57-71) vs 57% (54-61), 55% (48-62) vs 41% (38-45) and 52% (44-59) vs 38% (34-42), log rank test, p=0.016) with a lower risk of SEC discontinuation for these patients (HR: 0.70 (95% CI 0.5 to 0.88), Cox model, p=0.003).

Conclusion: This study suggests that reporting of recommended composites indices for monitoring axSpA might be associated with higher retention rates of biological therapies.