Secukinumab Effective for Psoriasis Yet High Rates of Adverse Events

Secukinumab was effective for patients with moderate to severe psoriasis, but was associated with a high rate of adverse events, according to data from a multicenter retrospective study published in Anais Brasileiros de Dermatologia.

Investigators included adult patients with psoriasis treated with secukinumab from March 2018 through November 2020. Secukinumab was administered to all patients at a standard dose of 300 mg subcutaneously once weekly for 5 weeks, and once a month thereafter. Investigators assessed Psoriasis Area and Severity Index (PASI) scores at 12, 24, and 52 weeks, and treatment efficacy was indicated by PASI 50, 75, 90, and 100 response rates. To evaluate secukinumab safety, investigators noted why treatment was discontinued in certain patients and any adverse events reported.

Of 229 patients included in the analysis, 60.7% were men, the mean age was 19 ± 78 years, and the mean disease duration was 215.4 ± 129.4 months. The most common comorbidity was hypertension which was reported in 17.9% of patients, 34.1% had psoriatic arthritis, and 31% had a BMI greater than 30 kg/m².

The mean baseline PASI score for all patients was 12 ± 42.5. At week 12 of treatment, 89.9% of patients achieved PASI 75, 79% achieved PASI 90, and 48% achieved PASI 100. In patients without comorbidities, the mean PASI score was lower at week 12 than in those with comorbidities, according to a Mann-Whitney U test (P =.034). At 24 weeks, there was a significant association between PASI score and disease duration, with shorter disease duration associated with a greater reduction in PASI score according to Spearman’s correlation analysis (P =.016).

There was no significant difference in PASI score improvement between patients who were bio-naïve and “bio-switched,” those with a BMI greater than 30 kg/m² and less than 30 kg/m², or those with and without arthritis. There was no significant association between age, sex, and number of biological therapies used before secukinumab and treatment effectiveness.

The rate of adverse events was 58.9%, with candida infection the most common (10.4%), followed by fatigue (7.42%) and nasopharyngitis (6.99%). There were no serious adverse events. Of 74 patients who discontinued secukinumab, 10.48% did so because of adverse events.

The study was limited by its retrospective design.

“These results show that factors such as the presence of comorbidities and disease duration can affect PASI responses in a negative way,” the study authors wrote.

Reference

Oguz Topal I, Baysak S, Altunay İK, et al. Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: real-world data from a retrospective multicenter study. An Bras Dermatol. Published online July 14, 2022. doi:10.1016/j.abd.2021.11.002