Secukinumab Effective in Real-world Clinical Usage in New Study

At 12 weeks, nearly 8 in 10 patients had significant improvement.

Secukinumab (Cosentyx) leads to significant improvement in people with moderate to severe psoriasis, according to a new study of real-world clinical use. The study also found that factors such as duration of disease and the presence of comorbidities have a notable impact on the success of the therapy.

Results were published in Anais Brasileiros de Dermatologia.

Secukinumab is a human monoclonal antibody that inhibits interleukin-17A, a cytokine that has been linked with the inflammation associated with psoriasis. In clinical trials, the therapy led to rapid and sustained improvement in people with moderate to severe psoriasis. Yet, the study investigators said there has been relatively little in the way of real-world data to confirm the safety and efficacy of the medication outside of a clinical trial setting.

For the new study, the investigators retrospectively analyzed 229 people who were treated at one of 9 referral centers between March 2018 and November 2020. A majority of the cohort was male (139 participants). The mean age was 19 years, and the median duration of disease as 215.4 months. The investigators tracked the success of the therapy by comparing Psoriasis Area and Severity Index (PASI) scores at baseline and at 12, 24, and 52 weeks of therapy. In addition to PASI scores, patient demographic data and medical histories were analyzed and compared to response rates.

At 12 weeks, 79% of patients had an improvement in PASI scores of at least 90 points, although this rate fell to 69.8% at 24 weeks and 49.3% at 52 weeks. When the investigators examined which patients were most likely to benefit from the therapy, they found those without comorbidities had greater improvement in PASI scores than those with comorbidities and that people with shorter disease durations also experienced a greater benefit.

In terms of safety, 58.9% of patients reported at least 1 adverse event (AE). The investigators said the most common AEs were Candida infections, fatigue, and nasopharyngitis, which were reported in 23, 17, and 16 patients, respectively. Seventy-four patients had discontinued treatment by 52 weeks due to AEs or secondary ineffectiveness.

The authors noted that their rate of Candida infections was significantly higher than that seen in similar studies, and they said this could be due, in part, to the thoroughness of their examinations for such infections.

Two limitations were noted. First, the researchers said the retrospective design of the study led to some difficulties in terms of obtaining access to data and the size of their cohort did not allow for analysis of certain smaller subgroups.

The investigators concluded that their study affirms the benefits of secukinumab in real-world settings and gives guidance on which patients are most likely to improve the most.

“​​These results show that factors such as the presence of comorbidities and disease duration can affect PASI responses in a negative way,” they concluded. “As in other studies, adverse events such as fatigue and nasopharyngitis occurred in the studied cohort.”

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. 2022;97(5):566-574. doi:10.1016/j.abd.2021.11.002