Real-world effectiveness and safety of secukinumab in giant cell arteritis: an Italian multicentre cohort study.

Abstract

The objective of this study was to evaluate the real-world effectiveness and safety of secukinumab in giant cell arteritis (GCA) patients. This multicentre retrospective study included patients with GCA who received secukinumab at 14 Italian centres with at least 6 months of follow-up. Outcomes included clinical, complete and glucocorticoid (GC)-free remission, GC dose reduction, drug retention rate and adverse events. Thirty-six patients were included (66.7% women); median age at secukinumab initiation was 74 (IQR 70-80) years. Overall, 32/36 patients (88.9%) had previously relapsed and 26/36 (72.2%) had received tocilizumab. Clinical remission was observed in 85.2%, 80.6% and 83.3% at 3, 6 and 12 months, respectively. Complete remission occurred in 55.6%, 52.8% and 63.3%, while GC-free remission increased progressively, reaching 14.8%, 27.8% and 40.0% at 3, 6, and 12 months, respectively (p = 0.012). Median daily GC dose decreased from 8.7 [4.0-21.2] mg at baseline to 0 [0-5.0] mg at 12 months (p < 0.001); GCs were discontinued in 12/28 patients (42.9%). The 12-month retention rate was 77.0%. Adverse events occurred in 20/36 patients (55.6%); infections occurred in 18/36 (50.0%) patients, accounting for 21 infectious episodes. In this multicentre real-world cohort of patients with GCA, including those with relapsing disease and previous biologic exposure, secukinumab was associated with high observed remission rates, progressive GC dose reduction and increasing GC-free remission. Although the phase III GCAptAIN trial did not meet its primary endpoint, these findings suggest that IL-17A inhibition may warrant further evaluation in GCA patients.