Table 1_Real-world use of ixekizumab for axial spondyloarthritis treatment in Spain (ESPADA study).docx

IntroductionWhile ixekizumab (IXE) has demonstrated efficacy in axial spondyloarthritis (axSpA) clinical trials, real-world evidence is limited. This study describes the characteristics and treatment persistence of axSpA patients receiving IXE in routine clinical practice in Spain.
MethodsA retrospective study of axSpA patients treated with IXE was carried out in ten hospitals. Demographic, clinical, treatment-related characteristics, persistence and disease activity were collected at baseline, 12, 24 and 52 weeks. Descriptive analysis and Kaplan–Meier methods were used.
ResultsThe study included 106 axSpA patients, 69.8% had r-axSpA, 58.5% were male, and 63% had overweight or obesity. Mean (SD) disease duration was 12.8 (12.3) years. 98.1% had received b/tsDMARDs and 52.5% presented normal C-reactive protein (CRP) levels at baseline. Persistence rates were 99.0, 80.5, and 56.3% at 12, 24, and 52 weeks, respectively. At week 52, 33.3% fewer patients had high/very high disease activity according to Ankylosing Spondylitis Disease Activity Index (ASDAS-CRP) scores and 18.9% showed an improvement of ≥50% in their Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Exploratory subanalyses showed IXE persistence was not influenced by gender, smoking status, BMI, axSpA clinical form, CRP levels, HLA-B27 status, prior biological (b) or targeted synthetic (ts) DMARD (b/tsDMARD) or secukinumab. IXE was discontinued by 40 (37.7%) patients during follow-up, mainly due to lack of effectiveness.
ConclusionMost axSpA patients treated with IXE had long-standing, highly active disease involving multiple domains and prior multiple domains and prior b/tsDMARDs (b/tsDMARD) exposure. Despite this, half remained on IXE at 1 year with improved disease activity, highlighting its potential as a treatment option in daily practice.