AB0551 TREATMENT WITH IXEKIZUMAB FOLLOWING SECUKINUMAB FAILURE IN PATIENTS WITH PSORIATIC ARTHRITIS: REAL-LIFE EXPERIENCE FROM A RESISTANT POPULATION

Background: Anti-IL17 agents, such as Secukinumab (SEC) and Ixekizumab (IXE) have been shown to be efficacious for the treatment of psoriasis PsA 12 . In field psoriasis, there is growing evidence a successful switching between two anti-IL-17 agents in case an insufficient response one treatments 3 There no information on efficacy anti IL17 PsA. Objectives: To assess clinical IXE patients with following SEC failure. Methods: A retrospective observational study was conducted rheumatology centers Israel, including history SEC, further treated minimum months. Lack efficacy, loss side effects over time were reported reason another anti-IL17 agent. The mean difference beginning follow up period different points (6 months) tested using one-sample t-test. Time until failure estimated Kaplan–Meier curves, compared log-rank test. Hazard ratios (HRs) corresponding 95% confidence intervals (CIs) calculated Cox proportional-hazards model test association each variable Results: included 23 (11♀/12♂), age 58.7 years±13.4 SD. Most (n=20, 86%) received 2+ TNFi 10 (43%) both ustekinumab. Median number biologics prior (IQR 2-4). significant improvement TJC at 6 months (-2.16 [-4.0, -0.3]; p=0.025 and-1.69 [-3.09, -0.28]; p=0.022, respectively). SJC significantly improved but not (-2.68 [-5.3, -0.04]; p= 0.046 -1.50 [-4.25,1.25]; p=0.26, CDAI score (-10.19, [-16.26, -4.1], p=0.002) (-9.29 [-14.8, -3.71], p=0.003) SDAI (-10.13 [-16.4, -3.8], p=0.003 -12.2 [-17.1, -7.2], p=0.0002). At six months, PASI50 achieved by 81% (13 patients), PASI75 63% (10 PASI90 50% (8 patients) PASI100 31% patients). 57% 43% 21% (3 Over time, IXE, 15 (65%) had experienced failure, median 8 6.5-13.5), which 4 (17%) primary 11 (48%) secondary Reasons cessation were: worsening (4 (27%)), peripheral arthritis (7 (47%)), axial disease (2 (13%)) adverse events (1 patient, 6%). Conclusion: after multiple biologic dermatologic they previously failed SEC. However, this refractory cohort PsA, effect limited 65% months.Within class switch from plausible therapeutic option secukinumab References: [1]Mease PJ, McInnes IB, Kirkham B, et al. N Engl J Med 2015;373(14):1329-1339. [2]Nash P, Okada M, Lancet Lond 2017;389(10086):2317-2327. [3]Bokor-Billmann T, Schäkel K. Dermatol Treat 2019;30(3):216-220 Disclosure Interests: None declared.