Secukinumab may be a safe and effective treatment for patients with psoriatic disease, comorbidities, and treatment failure, according to results of a retrospective study published in Dermatologic Therapy. The fully human IgG1/k monoclonal antibody has been shown to be safe and effective in the treatment of psoriasis in phase 3 trials, but has not yet been tested in the general population.
To determine the clinical effectiveness and safety of secukinumab in a real-life cohort of patients with moderate to severe psoriasis vulgaris, data from 120 patients (35.8% women) were analyzed. The mean age of participants was 49.8±13.5 years and 65% of participants were diagnosed with additional forms of psoriasis. The extent and severity of psoriasis was measured using the Psoriasis Area Severity Index (PASI).
After 3 months of secukinumab therapy, the mean PASI of the entire population was significantly lower than baseline (P <.001) and was maintained at 12 month follow-up (P <.001). Total clearance (PASI 0) was achieved after 12 months in 46% of those with psoriatic onychopathy (1 of the more difficult forms of psoriasis to treat), 75% of patients with moderate to severe scalp psoriasis, 57% of patients with psoriasis of the genital area, and 38% of patients with palmoplantar psoriasis. In all, 28 adverse effects were recorded in the first year of treatment, resulting in 8 patients discontinuing treatment. After 12 months, patients who had been unresponsive to 2 or more lines of biologic agents had a lower rate of treatment persistence (71%) than those who were bio-naive (93%) or had a history of inefficacy to only 1 biologic agent (88%)(P =.009 for trend).
Limitations to this study include its small cohort and retrospective design. Future research with a larger cohort and that investigates the impact of body mass index on therapeutic effectiveness are warranted.
The results of this study indicated to the researchers that secukinumab is effective and safe in the treatment of psoriasis in patients with a range of comorbidities and in areas that are difficult to treat. These results were significant despite a mean persistence to treatment of 85% after 12 months.
Disclosure: Medical writing assistance for this publication was provided by Novartis. Please see the original reference for a full list of authors’ disclosures.
Carpentieri A, Mascia P, Fornaro M, et al. Effectiveness and safety of secukinumab in patients with moderate-severe psoriasis: A multicenter real-life study. [published online July 18, 2020]. Dermatol Ther. doi:10.1111/dth.14044