Introduction <p>Long-term treatment of psoriatic arthritis (PsA) is required to prevent progression. However, persistence with current treatments is challenging due to tolerability and acceptability issues. The objective of this study was to estimate 1-year persistence with secukinumab in patients with PsA treated with secukinumab, to compare persistence rates between secukinumab and adalimumab, to estimate usefulness rates, and to document adverse events.</p> Methods <p>This retrospective study used data from the Japanese Medical Data Vision database. A total of 182 patients with PsA initiating secukinumab were identified between February 1, 2015 and September 30, 2020. Of these, 171 could be matched to 171 patients initiating adalimumab over the same period using a propensity score. Patients were followed until death, treatment discontinuation, or until the end of the study period. Persistence rates were analyzed using Kaplan–Meier survival analysis. Usefulness was evaluated using a published algorithm. Selected adverse events were documented.</p> Results <p>Twelve-month persistence with secukinumab was 68.3%. The median persistence duration was significantly higher (<i>p</i> = 0.002) for secukinumab (27.8&#xa0;months) than for adalimumab (12.5&#xa0;months). After 12&#xa0;months, the treatment was found to be useful in 47.0% of the secukinumab cohort and 22.2% of the adalimumab cohort (<i>p</i> &lt; 0.001). Fourteen patients (7.7%) in the unmatched secukinumab cohort and 32 (9.1%) in the unmatched adalimumab cohort presented an adverse event of interest.</p> Conclusions <p>Patients with PsA showed higher persistence with secukinumab than with adalimumab. Since PsA is a chronic disease that requires long-term treatment, long-term persistence and usefulness should be considered for the treatment choice.</p> <p>Infographic available for this article.</p> Infographic <p></p>