Spondyloarthritis & psoriatic arthritis
Long-term comparative analysis of secukinumab versus TNFα inhibitors in patients with spondyloarthritis: treatment persistence is differentially affected by disease phenotype, obesity and sex
Authors' conclusion
The differential persistence of biologic agents commonly used in SpA has been shown in this real-life prospective study.
Study context
- Population
- Consecutive axial SpA (axSpA) or peripheral spondyloarthritis (SpA) patients, including psoriatic arthritis (PsA), starting or switching to secukinumab or TNFi in routine care, 2016–2022, single centreanalysed
- Participants
- 644 participants
- Exposure
- Secukinumab vs TNFi in SpA
- Secukinumabn = 214
- Tumor necrosis factor inhibitors (TNFis)n = 430reference
- Outcome
- Long-term treatment persistence
- Follow-up
- 4 years
Methodological detailssingle-centre, consecutive patients, multivariable and propensity score-adjusted regression
- Single-centre
- Consecutive patients
- Multivariable and propensity score-adjusted regression
Main finding
As reported in the abstract
Unadjusted treatment persistence, total SpA cohort
HR for discontinuation (multivariable)
1.62
95% CI 1.23–2.14
P < 0.001
By group
Observational data: associations, not effects.
Further findings
Treatment persistence, axSpA cohort · 4 years
P = 0.044
Treatment persistence, perSpA cohort · 4 years
P = 0.011
Persistence, obese female PsA patients (subgroup) · 2 years
Persistence, nonobese axSpA males (subgroup) · 2 years
| Outcome | HR (95% CI) | |
|---|---|---|
| Discontinuation for inefficacy | 1.38 (1.01–1.90) | |
| Discontinuation for safety reasons | 2.95 (1.22–7.14) | |
| 0.10.31310Hazard ratio (log scale) |
- Persistence, obese female PsA patients (subgroup): PsA, obesity and female sex significantly modified efficacy-related persistence
Treatment target achievement in axSpA, peripheral SpA (perSpA) and PsA · 6 months
- Comparable between the two agents
Original publication
Long-term comparative analysis of secukinumab versus TNFα inhibitors in patients with spondyloarthritis: treatment persistence is differentially affected by disease phenotype, obesity and sex. Arthritis Res Ther. Published 3 November 2025. doi:10.
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