CO22 Use of Ixekizumab for Psoriatic Arthritis Patients in Real-World Conditions

To describe patient´s characteristics, treatment patterns, persistence and effectiveness of ixekizumab in psoriatic arthritis (PsA) patients in a real-world setting. Retrospective study conducted in 8 Spanish rheumatology units, including adult patients with PsA who started ixekizumab treatment between January 1, 2019 and December 31, 2020, with a minimum follow-up of 24 weeks until treatment interruption/end of follow-up. Demographic/clinical characteristics, treatment patterns and changes in the Disease Activity in Psoriatic Arthritis (DAPSA) were collected. Continuous data were presented as mean (standard deviation (SD)) and categorical variables as count and percentage. Effectiveness was evaluated by changes from baseline until 12/24 weeks, using paired t-test. Treatment persistence was estimated by Kaplan-Meier method. Eighty-nine patients were analyzed: mean age at ixekizumab initiation 51.5 (11.6) years; 55.1% women; mean body mass index 24,1 (4.8) kg/m2. Mean time from PsA diagnosis was 10.3 (9,0) years, 55.1% peripheral, 13.6% axial, and 30.3% both. Before starting ixekizumab, 79.8% of patients received at least one conventional synthetic disease-modifying antirheumatic drug (csDMARD; mean, 1.8) and 95.5% had been treated with one or more targeted synthetic or biologic disease-modifying antirheumatic drug (ts/bDMARD; mean, 2.7). The proportion of patients starting ixekizumab in combination with a csDMARD was 37.1% (79% methotrexate). The median persistence was not reached in the study period (mean persistence, 86,9 [95% CI 80.6-93.2] weeks). Treatment persistence rates were 95.5/84.3/68.5% at 24/48/104 weeks. Twenty-one (23.5%) patients discontinued ixekizumab due to loss of effectiveness (21.3%) or adverse events (2.2%). Mean DAPSA score in patients with available information (n=24) at the observed cut-off points decreased significantly from 23.7 (9.8) at baseline to 14.8 (10.3) and 14.3 (7.4) at 12/24 weeks, respectively (p-value 0.005). This Spanish cohort of PsA patients treated with ixekizumab had a long-standing and refractory disease. Nevertheless, they showed high treatment persistence and improvements in disease activity after initiating ixekizumab.