Secukinumab vs Ustekinumab Effects on Quality of Life in Patients With Psoriasis

In patients with moderate to severe psoriasis, treatment with secukinumab was associated with greater and sustained benefits compared with ustekinumab therapy, according to the results of a recent patient-reported outcome (PRO) analysis from the 52-week CLEAR study, which was published in the Journal of the American Academy of Dermatology. 

The aim of the current PRO analysis was to assess the effects of secukinumab vs ustekinumab on complete relief from psoriasis-related symptoms, time to health-related quality of life (HRQOL) response, and cumulative benefit in individuals with moderate to severe plaque psoriasis.

Psoriasis-related pain, itching, and scaling, and Dermatology Life Quality Index (DLQI) scores of both treatments were compared based on time to complete symptom relief and DLQI response in the CLEAR trial. Area-under-the-curve (AUC) analysis was used to evaluate the cumulative benefit over 52 weeks based on the Psoriasis Area and Severity Index (PASI), symptom relief, and DLQI response.

A total of 675 participants were randomly assigned to receive secukinumab (n=336) or  ustekinumab (n=339) and included in the analysis. The patients were predominantly male (68% secukinumab, 74% ustekinumab) and approximately 45 years of age (mean age with secukinumab: 45.2; mean age with ustekinumab: 44.6). The majority of participants reported some level of pain (77.7% with secukinumab vs 76% with ustekinumab); almost all patients reported itching (97%) and scaling (99%) at baseline.

Results from this PRO analysis demonstrated that significantly more secukinumab-treated patients achieved complete relief of pain at weeks 16 and 52 compared with ustekinumab-treated patients (P <.05 for both time periods). Moreover, complete relief of itching and scaling occurred significantly faster with secukinumab (median: 4 weeks faster for itching and 8 weeks faster for scaling) vs ustekinumab (P <.0001). Cumulative benefits based on PASDI 75/90/100 responses were significantly greater with secukinumab than with ustekinumab (P <.05 for all).

The investigators concluded that this PRO analysis confirms the greater and sustained benefits of treatment with secukinumab vs ustekinumab on HRQOL in patients with psoriasis. Secukinumab is a reasonable therapeutic option for the treatment of psoriasis based on objective and patient-reported measures.

Reference

Puig L, Augustin M, Blauvelt A, et al. Effect of secukinumab on quality of life and psoriasis-related symptoms: a comparative analysis versus ustekinumab from the CLEAR 52-week study [published online October 21, 2017]. J Am Acad Dermatol. doi:10.1016/j.jaad.2017.10.025