Predisposing factors of discontinuation of secukinumab
| Predictive factor | Modality* | Cox regression model | |||
| Univariate | Multivariate | ||||
| HR† (95% CI) | P value | HR (95% CI) | P value | ||
| Optimal report of a composite index‡ | Yes: n=197 No n=706 | 0.69 (0.55 to 0.87) | 0.002 | 070 (0.55 to 0.88) | 0.003 |
| Centre size no of enrolled patients | >10 patients: n=744 ≤10 patients: n=159 | 1.57 (1.21 to 2.04) | <0.001 | 1.50 (1.16 to 1.95) | 0.002 |
| Age (years) | >46 years: n=452 ≤46 years: n=451 | 0.80 (0.67 to 0.96) | 0.014 | 0.84 (0.70 to 1.01) | 0.060 |
| Sex§ | Female; n=523 Male; n=380 | 1.24 (1.03 to 1.48) | 0.023 | ||
| HLA B27 | Positive; n=527 Negative; n=298 | 0.91 (0.76 to 1.10) | 0.350 | ||
| Smoking status | Current; n=231 Former; n=158 Never; n=326 | 0.97 (0.75 to 1.27) | 0.849 | ||
| Body mass index | ≥30; n=133 ≥25–30; n=186 ≥18.5-<25; n=200 <18.5; n=12 | 1.21 (0.89 to 1.86) | 0.228 | ||
| Disease duration (years) | >6.4 years: n=400 ≤6.4 years: n=405 | 0.84 (0.69 to 1.01) | 0.060 | 0.79 (0.66 to 0.95) | 0.011 |
| Uveitis (past or present) | Yes; n=131 No; n=725 | 0.91 (0.71 to 1.18) | 0.483 | ||
| IBD (past or present) | Yes; n=22 No; n=853 | 1.67 (1.00 to 2.79) | 0.051 | 1.82 (1.08 to 3.06) | 0.024 |
| Psoriasis (past or present) | Yes; n=194 No; n=680 | 1.02 (0.82 to 1.26) | 0.876 | ||
| Arthritis (past or present) | Yes; n=258 No; n=543 | 0.95 (0.77 to 1.16) | 0.600 | ||
| Objective sign of inflammatin (at least one) | Yes; n=616 No; n=97 | 1.10 (0.82 to 1.49) | 0.524 | ||
| Enthesitis (past or present) | Yes; n=373 No; n=530 | 0.87 (0.72 to 1.06) | 0.180 | 0.83 (0.69 to 1.00) | 0.045 |
| Secukinumab line of therapy | ≥3 rd: n=692 first/2nd: n=204 | 1.24 (0.99 to 1.55) | 0.057 | 1.28 (1.02 to 1.60) | 0.033 |
*The modality given in the second raw (eg, ‘No’ for ‘optimal report of a composite index’) defined the reference in the cox model.
†HR (95% CI): HR and its (95% CI) (a value above one indicates a higher risk of discontinuation of secukinumab.
‡Reporting of a composite index=number of patients for whom a recommended composite index (either Bath Ankylosing Spndylitis Disease Activity Index (BASDAI)+CRP or Ankylosing Sondylitis Disease Avtivity Score (ASDAS) has been reported in the medical file at the time of initiation of secukinumab and at least once during the first year of follow-up.
§This variable ‘sex’ was excluded during the stepwise logistic regression analysis (p=0.17).
CRP, C reactive protein; IBD, inflammatory bowel disease.