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BACKGROUND • Psoriasis (PsO) is a chronic, inflammatory disease that affects the skin, with an estimated prevalence of 2.6% to 3.7% in the United States1 • PsO is associated with many comorbidities, including psoriatic arthritis (PsA)2; up to 30% of patients with PsO may have a concurrent diagnosis of PsA3,4 • Secukinumab is a fully human, interleukin-17A inhibitor approved for treatment of both PsA and PsO; it has demonstrated significant efficacy in moderate to severe plaque PsO, improvement of physical functioning and quality of life, resolution of enthesitis and dactylitis, and inhibits progression of joint structural damage5-9 • Little is known about treatment satisfaction and symptom control with secukinumab among patients with PsA and PsO in a real-world setting OBJECTIVE • To evaluate patient-reported secukinumab treatment satisfaction and PsA symptom control in US patients with PsO in conjunction with PsA in a real-world setting METHODS Study Design and Patient Population • Data were collected from a cross-sectional, panel-based web survey of patients with PsA in the United States – A random sample of patients were invited to participate in the survey by Survey Sampling International through their patient panels – Of 2755 patients screened for PsA or ankylosing spondylitis (AS), 269 patients with PsA were eligible for the analysis • Eligible patients were ≥ 18 years of age with a self-reported diagnosis of PsA, initiated secukinumab ≥ 3 months before survey participation, and had received secukinumab continuously since initiation – Of the 269 eligible patients with PsA, 266 completed the survey; 66 patients had concurrent AS and were not included in this analysis, and 3 did not consent to participate – Patients included in this analysis also had a self-reported diagnosis of PsO in conjunction with active PsA Study Variables and Data Analysis • Patient characteristics, including demographics, clinical characteristics, and medication history, were assessed at the time of survey participation • The primary outcomes were satisfaction with secukinumab treatment and with PsA symptom control, including joint pain or tenderness, pain disrupting sleep, swelling of entire finger or toe, fatigue, morning stiffness, ankle and heel pain, and sore areas other than joints • Descriptive analyses were conducted for each question; data were summarized using frequency counts and percentages for categorical variables and mean and standard deviation for continuous variables RESULTS Patient Population • Of eligible patients with PsA who completed the survey; 56 patients (28.0%) with concurrent PsO were included in this analysis – Demographics and patient characteristics are shown in Table 1 • Most patients (89.3%) received ≥ 1 biologic prior to secukinumab treatment (Table 1) US Patient Satisfaction With Secukinumab Treatment Among Patients With Both Psoriatic Arthritis and Psoriasis: Data From a Web-Based Survey Marina Magrey, MD,1 Daniel Wolin, BS,2 Margaret Mordin, MS,2 Lori McLeod, PhD,2 Eric Davenport, MEcon, MStat,2 Peter Hur, PharmD, MBA3 1Case Western Reserve University, Cleveland, OH; 2RTI-Health Solutions, Research Triangle Park, NC; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ Your document will be available for download at the following URL: http://http://novartis.medicalcongressposters.com/Default.aspx?doc=305c7 And via Text Message (SMS) Text: Q305c7 To: 8NOVA (86682) US Only +18324604729 North, Central and South Americas; Caribbean; China +447860024038 UK, Europe & Russia +46737494608 Sweden, Europe Note: downloading data may incur costs which can vary depending on your service provider and may be high if you are using your smartphone abroad. Please check your phone tariff or contact your service provider for more details. Presented at the 2018 Winter Clinical Dermatology Conference; January 12-17, 2018; Lahaina, HI. Table 1. Patient demographics and clinical characteristics Characteristics Patients With PsA and PsO(N = 56) Age, mean (SD) 35.7 (10.6) Male, n (%) 33 (58.9) Race*, n (%) White 46 (82.1) Hispanic 21 (37.5) Black 5 (8.9) Other 4 (7.1) Region, n (%) East 10 (17.9) South 17 (30.4) Midwest 19 (33.9) West 10 (17.9) Years since PsA symptom onset, mean (SD) 4.4 (4.6) Years since diagnosis with PsA, mean (SD) 3.6 (4.1) Deformities due to PsA, n (%) 45 (80.4) Comorbidity*, n (%) Anxiety 33 (58.9) Depression 26 (46.4) Obesity 22 (39.3) Fatigue 21 (37.5) Prior biologic use, n (%) Biologic experienced 50 (89.3) Biologic naive 6 (10.7) Biologic use prior to secukinumab, n (%) Adalimumab 32 (57.1) Certolizumab pegol 21 (37.5) Etanercept 31 (55.4) Golimumab 18 (32.1) Infliximab 19 (33.9) Rituximab 19 (33.9) Ustekinumab 12 (21.4) Ixekizumab 18 (32.1) PsA, psoriatic arthritis; PsO, psoriasis. * Patient may select all that apply. Discontinuation of Prior Treatments • Lack of efficacy (27.3%) was the most frequently cited reason for the discontinuation of previous treatment (Figure 1) PsA Symptoms Before and After Secukinumab Initiation • 85.7% of patients reported better overall symptom control after secukinumab initiation compared with before secukinumab initiation (“a little better,” 26.8%; “moderately better,” 39.3%; “much better,” 19.6%) (Figure 2) – Better symptom control was noted for each PsA symptom assessed in the online survey (Figure 2) Time to Symptom Improvement After Secukinumab Initiation • Of the patients who reported overall PsA symptom improvement after secukinumab initiation (n = 48), the majority (n = 30; 62.5%) noticed overall symptom improvement within 4 weeks of initiating secukinumab; ≈ 90% of patients experienced improvement within 6 months (Figure 3) • ≥ 50% of patients experienced a fast improvement (within 2 weeks) in joint pain and fatigue Figure 3. Patient-reported time to first noticeable improvements in PsA disease symptoms since secukinumab initiation 40.6 16.1 43.6 51.4 34.2 27.0 50.0 16.7 34.4 64.5 35.9 20.0 44.7 48.6 23.8 45.8 15.6 9.7 12.8 20.0 13.2 13.5 19.0 22.9 3.1 6.5 5.1 5.7 5.3 5.4 4.8 10.4 6.2 3.2 2.6 2.9 2.6 5.4 2.4 4.2 0 10 20 30 40 50 60 70 80 90 100 Ankle or Heel Pain† Sore Areas Other Than Joints Morning Stiffness Fatigue Swelling of Entire Finger/Toe* Pain Disrupting Sleep Joint Pain or Tenderness Overall Current PsA Symptoms Proportion of Patients, % Within 2 Weeks 3-4 Weeks 1-2 Months 3-6 Months > 6 Months * An indicator of dactylitis. † An indicator of enthesitis. Treatment Satisfaction With Secukinumab • The majority of patients with PsO in conjunction with PsA expressed overall satisfaction (“very satisfied” and “mostly satisfied”) with their secukinumab treatment experience (Figure 4) • Most patients also reported better treatment experience with secukinumab compared with their previous treatment (Figure 5) – > 90% of patients experienced better overall symptom improvement compared to their previous treatment Figure 4. Overall treatment satisfaction with secukinumab (N = 56) 64.3 33.9 55.4 58.9 55.4 41.1 71.4 26.8 57.1 32.1 26.8 30.4 53.6 21.4 7.1 7.1 12.5 14.3 14.3 5.4 7.1 1.8 1.8 0 10 20 30 40 50 60 70 80 90 100 Patient Support Services Side Effects Ease of Use Method of Administration Frequency of Treatment Speed of Symptom Improvement Symptom Improvement Proportion of Patients, % Very Satisfied Mostly Satisfied Somewhat Satisfied Not Satisfied Figure 5. Treatment experience with secukinumab compared with previous treatment (N = 56) 72.7 58.2 54.5 67.3 63.6 58.2 56.4 90.9 25.5 38.2 40.0 30.9 36.4 38.2 43.6 9.1 1.8 3.6 5.5 1.8 3.6 0 10 20 30 40 50 60 70 80 90 100 Ease of Switching to Secukinumab Patient Support Services Side Effects Ease of Use Method of Administration Frequency of Medication Speed of Symptom Improvement Overall Symptom Improvement Proportion of Patients, % Secukinumab Better About the Same Previous Treatment Better LIMITATIONS • The patient population in this analysis was small (N = 56) • As with all survey-based research, patient perspectives may be subject to the patients’ bias and experience • This is a cross-sectional study which may be influenced by recall bias CONCLUSIONS • In this real-world analysis, > 60% of patients with PsO in conjunction with PsA experienced overall symptom improvement within 4 weeks of initiating secukinumab • The majority of patients were satisfied with secukinumab treatment and reported better treatment experience with secukinumab than with their previous treatment • These results provide early insight into secukinumab treatment satisfaction among US patients with PsO in conjunction with PsA REFERENCES 1. Rachakonda TD, et al. J Am Acad Dermatol. 2014;70(3):512-6. 2. Greb JE, et al. Nat Rev Dis Primers. 2016;2:16082. 3. Reich K, et al. Br J Dermatol. 2009;160(5):1040-7. 4. Mease PJ, et al. J Am Acad Dermatol. 2013;69(5):729-35. 5. Langley RG, et al. N Engl J Med. 2014;371(4):326-38. 6. Mease PJ, et al. N Engl J Med. 2015;373(14):1329-39. 7. McInnes IB, et al. Lancet. 2015;386(9999):1137-46. 8. Kavanaugh A, et al. Arthritis Care Res (Hoboken). 2017;69(3):347-55. 9. Husted JA, et al. Arthritis Care Res (Hoboken). 2011;63(12):1729-35. DISCLOSURES M. Magrey received research funding from AbbVie for clinical trials; served as a consultant for Janssen and Novartis; and was a member of an advisory board for Janssen, Novartis, and UCB. D. Wolin, M. Mordin, L. McLeod, and E. Davenport are employees of RTI-Health Solutions. P. Hur is an employee of Novartis. ACKNOWLEDGMENTS Support for third-party writing assistance for this poster, furnished by Kheng Bekdache, PhD, of Health Interactions, Inc, was provided by Novartis Pharmaceuticals Corporation, East Hanover, NJ. This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ. © 2017 Novartis Pharmaceuticals Corporation. Figure 1. Reasons for discontinuation of previous treatment prior to secukinumab treatment (N = 55) 1.8 3.6 3.6 5.5 7.3 10.9 16.4 23.6 27.3 Too Many Doctor Visits Decline of Insurance Coverage High Frequency of Dosing High Co-Pay Inconvenient Treatment Regimen Painful Injection/Infusion Fear of Injections/Needles Side Effects Lack of Efficacy 0 10 20 30 40 50 Proportion of Patients, % Figure 2. Improvement in PsA symptoms with secukinumab compared with before secukinumab initiation * An indicator of dactylitis. † An indicator of enthesitis. 0 0 5.8 6.7 0 2.2 9.1 1.8 5.3 4.8 1.9 2.2 6.1 10.9 0 7.1 0 7.1 5.8 6.7 8.2 0 3.8 0 10.5 14.3 11.5 6.7 8.2 6.5 7.5 5.4 18.4 14.3 21.2 15.6 12.2 23.9 22.6 26.8 36.8 40.5 15.4 24.4 38.8 39.1 20.8 39.3 28.9 19.0 38.5 37.8 26.5 17.4 35.8 19.6 0 10 20 30 40 50 60 70 80 90 100 Ankle or Heel Pain† Sore Areas Other Than Joints Morning Stiffness Fatigue Swelling of Entire Finger/Toe* Pain Disrupting Sleep Joint Pain or Tenderness Overall Proportion of Patients, % A Lot Worse Moderately Worse A Little Worse No Change A Little Better Moderately Better Much Better