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Kim BS, Kim DH, Shin BS, Lee ES, Jo SJ, Bang CH, Yun Y, Choe YB. Real-world safety and effectiveness of secukinumab in adult patients with moderate to severe plaque psoriasis: results from postmarketing surveillance in Korea. Ther Adv Chronic Dis 2024; 15:20406223241230180. [PMID: 38415046 PMCID: PMC10898308 DOI: 10.1177/20406223241230180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/10/2024] [Indexed: 02/29/2024] Open
Abstract
Background Secukinumab, a fully human monoclonal antibody, was approved in Korea for the treatment of moderate to severe psoriasis in September 2015. Objectives To assess the safety and effectiveness of secukinumab in patients with moderate to severe psoriasis in Korea. Design Multicenter, real-world, noninterventional study conducted over 6 years. Methods Adults with moderate to severe psoriasis were enrolled. Safety was assessed by evaluating adverse events (AEs), treatment-related AEs, and serious AEs (SAEs). Effectiveness was assessed using the change in absolute Psoriasis Area and Severity Index (PASI) score, percentage of patients achieving PASI 75/90/100 and PASI ⩽2; at weeks 12 and 24. Results Overall, 829 and 542 patients were included in the safety and effectiveness sets, respectively. AEs, treatment-related AEs, and SAEs occurred in 29.0%, 9.5%, and 4.1% of patients, with incidence rates of 39.43, 12.98, and 5.59 per 100 patient years, respectively. The absolute PASI score decreased from 16.1 ± 7.1 (baseline) to 1.6 ± 2.4 (week 24), with a similar reduction in biologic-naïve (16.4 ± 7.3 to 1.5 ± 2.2) and biologic-experienced (14.8 ± 5.9 to 2.4 ± 3.2) groups. At week 24, PASI 75/90/100 was achieved by 95.1%, 62.4%, and 24.9% of patients. At week 24, PASI 75/90 were higher in biologic-naïve (96.6%/65.8%) than biologic-experienced patients (88.3%/48.6%), whereas PASI 100 was similar in both cohorts (24.1% and 28.6%). A similar trend in PASI ⩽ 2 was observed in both cohorts. Conclusion Secukinumab showed sustained effectiveness and favorable safety profile in adult patients with moderate to severe psoriasis in Korea.
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Affiliation(s)
- Byung Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Dong Hyun Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Hospital, Gwangju, Republic of Korea
| | - Eun-So Lee
- Department of Dermatology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeojun Yun
- Novartis Korea Ltd, Seoul, Republic of Korea
| | - Yong Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
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Loft N, Egeberg A, Isufi D, Rasmussen MK, Bryld LE, Dam TN, Ajgeiy KK, Bertelsen T, Skov L. Response to Interleukin-17A Inhibitors According to Prior Biologic Exposures: A Danish Nationwide Study. Acta Derm Venereol 2023; 103:adv12616. [PMID: 37987625 PMCID: PMC10680979 DOI: 10.2340/actadv.v103.12616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023] Open
Abstract
Whether response to an interleukin (IL-17) inhibitor is different in patients with previous exposure to an IL-17 inhibitor compared with patients with exposure to biologics with other cytokine targets remains to be elucidated. Therefore, the aim of this study was to assess whether previous exposure to an IL-17A inhibitor was associated with worse response than exposure to (an)other biologic(s). All patients in the DERMBIO register treated with an IL-17A inhibitor (secukinumab or ixekizumab) were included. With an absolute Psoriasis Area and Severity Index (PASI) ≤ 2 as response, the proportion of responders treated with IL-17A inhibitors was assessed in patients previously treated with another IL-17A inhibitor and compared with patients with previous exposure to (an)other biologic(s), using a χ2 test. In total, 100, 93 and 83 patients with previous exposure to an IL-17A inhibitor and 414, 372 and 314 patients with previous exposure to (an) other biologic(s) were assessed after 3, 6 and 12 months, respectively. No differences in the proportion of patients achieving PASI ≤ 2 were observed between the 2 groups after 3 months (54% vs 57%, p = 0.59), 6months (70% vs 66%, p = 0.42) and 12 months (69% vs 60%, p = 0.14). In conclusion, when treating patients with IL-17A inhibitors the cytokine target of the previous biologic does not appear to affect the response.
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Affiliation(s)
- Nikolai Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Daniel Isufi
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Mads K Rasmussen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars E Bryld
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Tomas N Dam
- Dermatology Clinic, Nykoebing Falster, Denmark
| | - Kawa K Ajgeiy
- Department of Dermatology, Odense University Hospital, Odense, Denmark
| | - Trine Bertelsen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Ding Y, Li W, Guan X, Liu N, Zhou Y, Li G, Wang X, Wang Z, Xiao X, Yang B, Lv C, Zhang C, Shi Y. Treatment outcomes of secukinumab in adult patients with moderate-to-severe plaque psoriasis in China: A real-world multicenter retrospective study. Clin Transl Sci 2023; 16:1803-1814. [PMID: 37644777 PMCID: PMC10582683 DOI: 10.1111/cts.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 05/15/2023] [Accepted: 06/04/2023] [Indexed: 08/31/2023] Open
Abstract
Secukinumab is effective in treating patients with moderate-to-severe plaque psoriasis. However, most studies assessing its effectiveness in routine clinical settings in China are mostly single-center studies with a limited sample size. The objective of this study was to assess secukinumab's efficacy, treatment patterns, and characteristics in patients with moderate-to-severe plaque psoriasis. This 24-week, multicenter (n = 5) retrospective study analyzed the data of Chinese adult patients with moderate-to-severe plaque psoriasis who initiated secukinumab treatment between May 2019 and March 2020. The Psoriasis Area and Severity Index (PASI), body surface area (BSA), Investigator's Global Assessment Modified 2011 (IGA mod 2011), and Dermatology Life Quality Index (DLQI) were assessed. Dermatologists documented the treatment dosage and modification reasons. Of the 244 secukinumab-naïve patients, most were men (73.4%, 179/244) and weighed 60-90 kg (72.8%, 177/243). The mean (SD) age at secukinumab initiation was 38.1 (11.6) years, and the disease duration was 13.5 (7.9) years. Most patients (97.1%, 237/244) received secukinumab 300 mg. At weeks 4, 12, 16, and 24, the proportion of patients achieving PASI 75 (≥75% reduction from baseline) was 40.0%, 92.1%, 88.4%, and 88.9%, respectively; PASI 90 was 15.0%, 73.7%, 81.4%, and 68.3%, respectively; and PASI 100 was 8.7%, 40.8%, 58.1%, and 41.3%, respectively. During the same periods, BSA and IGA mod 2011 showed similar improvement trends. An increasing proportion of patients achieved DLQI of 0-1 (21.6%, 65.7%, 75.0%, and 80.3%, respectively). Treatment modification was highest at week 12. The average interval between two administrations after week 4 was 62.95 days. Secukinumab was highly effective in improving the PASI, IGA, BSA, and DLQI in Chinese patients with moderate-to-severe plaque psoriasis throughout the first 24 weeks. The treatment pattern for Chinese patients differs from that in the clinical guidelines.
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Affiliation(s)
- Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease HospitalTongji University School of MedicineShanghaiChina
| | - Wei Li
- Department of Dermatology & Rare Disease CenterWest China Hospital of Sichuan University37# Guoxue Alley, Wuhou DistrictChengduChina
| | - Xin Guan
- Peking University Third HospitalBeijingChina
| | - Na Liu
- Shanghai Sixth People's HospitalShanghaiChina
| | - Ying Zhou
- Dalian Dermatology HospitalDalianChina
| | - Gaojie Li
- Department of Dermatology & Rare Disease CenterWest China Hospital of Sichuan University37# Guoxue Alley, Wuhou DistrictChengduChina
| | - Xiaohua Wang
- Dermatology Hospital, Southern Medical UniversityGuangzhouChina
| | | | - Xiao Xiao
- Beijing Novartis Pharma Co., Ltd.BeijingChina
| | - Bin Yang
- Dermatology Hospital, Southern Medical UniversityGuangzhouChina
| | | | | | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease HospitalTongji University School of MedicineShanghaiChina
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Nguyen HT, Pham NTU, Tran TNA, Pham NN, Bui YT, Vu TTP. Long-Term Effectiveness and Drug Survival of Secukinumab in Vietnamese Patients with Psoriasis: Results from a Retrospective ENHANCE Study. Dermatol Ther (Heidelb) 2023; 13:465-476. [PMID: 36472791 PMCID: PMC9884729 DOI: 10.1007/s13555-022-00867-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Psoriasis (PsO), an immune-mediated inflammatory skin disorder, has substantial negative impact on patients' quality of life. Secukinumab, an approved treatment for moderate-to-severe plaque PsO, has an established long-term efficacy and safety profile. This study aims to provide real-world evidence of long-term effectiveness and retention rate of secukinumab in Vietnamese patients with PsO. METHODS This retrospective, observational study collected medical records of adult patients with moderate-to-severe PsO receiving secukinumab treatment from Ho Chi Minh City Hospital of Dermato-Venereology. The primary objective was to evaluate secukinumab effectiveness in PsO as measured by 75% improvement in psoriasis area and severity index (PASI 75) at month 12. Secondary objectives were PASI 90/100, absolute PASI ≤ 3 and ≤ 5, Dermatology Life Quality Index (DLQI), and retention rate over 48 months. RESULTS In total, 232 patients with moderate-to-severe PsO met inclusion criteria; 68.1% were male, with median age and age of onset of 39 and 27.5 years, respectively. Median time from onset of PsO to secukinumab treatment was 120 months, 95.3% were prior biologics/disease-modifying antirheumatic drugs naive and 41.4% received concomitant therapies for PsO; 82.3% had national insurance coverage. At month 12, 93.9% of patients achieved PASI 75 (primary endpoint); 80.2/56.9% achieved PASI 90/100; 91.4 and 84.8% patients achieved absolute PASI ≤ 5 and ≤ 3, respectively. The response was sustained over 48 months, with 91.9%/78.0%/52.0% of patients achieving PASI 75/90/100, 89.5% and 82.1% patients achieving absolute PASI ≤ 5 and ≤ 3, respectively. At month 12, 61.4% of patients achieved DLQI 0/1 which was sustained up to month 48 (69.2%). Secukinumab adherence rate of 84.9% at month 12 dropped to 34.2% at month 48. Patients receiving concomitant therapy and national insurance showed higher adherence rate. CONCLUSION Secukinumab demonstrated long-term effectiveness in real-world Vietnamese patients with moderate-to-severe PsO, with treatment adherence being higher in patients having concomitant therapies and national insurance.
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Affiliation(s)
- Hao Trong Nguyen
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, Ward Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam.
| | - Nhi Thi Uyen Pham
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, Ward Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam
| | - Tu Nguyen Anh Tran
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, Ward Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam
| | - Nguyen Nhat Pham
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, Ward Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam
| | - Yen Thi Bui
- Novartis Vietnam Company Limited, Ho Chi Minh City, 700000, Vietnam
| | - Thao Thi Phuong Vu
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, Ward Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam
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Stingeni L, Malara G, Conti A, Di Costanzo L, Carrera CG, Burlando M, Malagoli P, Musumeci ML, Bardazzi F, Brazzelli V, Amerio P, De Simone C, Trevisini S, Balato A, Megna M, Loconsole F, De Felice C, Bartezaghi M, Rausa A, Aloisi E, Orsenigo R, Costanzo A. Efficacy of Secukinumab in Psoriasis: Post Hoc Gender-Wise Analysis of the SUPREME Study. Clin Cosmet Investig Dermatol 2023; 16:27-38. [PMID: 36636635 PMCID: PMC9829832 DOI: 10.2147/ccid.s378135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/02/2022] [Indexed: 01/05/2023]
Abstract
Purpose Psoriasis, a common systemic inflammatory disorder, presents with gender-related differences in the quality of life (QoL) and treatment outcomes. This post hoc analysis from the Phase 3b SUPREME study explored gender-related differences in patient characteristics and efficacy of secukinumab 300 mg on Psoriasis Area and Severity Index (PASI) 75/90/100 and impact on QoL using the Dermatology Life Quality Index (DLQI) in patients with moderate to severe psoriasis through week 24. Patients and Methods The proportion of patients achieving PASI 75/90/100 was computed using a nonresponder imputation approach. Differences between cohorts were analyzed using a logistic regression model. The mean change from baseline in DLQI was computed using the Wilcoxon test. Results Among the 433 patients (males: 71.6%), females had a higher DLQI than males at baseline (13.1 vs 9.5; P<0.0001). Males had a slightly higher response for PASI 90 than females at week 16 (80.7% vs 78.1%; P=0.0779) and 24 (83.2% vs 79.7%; P=0.0319). No differences were observed between genders in PASI 100/75 responses at week 24. Both genders showed an improvement in DLQI with secukinumab at week 24 (-10.9 vs -8.1, respectively, in females vs males; P=0.0004). Conclusion In summary, secukinumab was effective in the treatment of psoriasis, irrespective of gender.
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Affiliation(s)
- Luca Stingeni
- Dermatology Section, Medical and Surgical Department, University of Perugia, Perugia, Italy,Correspondence: Luca Stingeni, Dermatology Section, Medical and Surgical Department, University of Perugia, Perugia, Italy, Tel +39075-5783881, Email
| | - Giovanna Malara
- Dermatology Unit, Hospital “Bianchi Melacrino Morelli”, Reggio Calabria, Italy,Department of Dermatology, Papardo Hospital, Messina, Italy
| | - Andrea Conti
- Dermatologic Unit, Department of Surgery, Infermi Hospital, AUSL Romagna, Rimini, Italy
| | - Luisa Di Costanzo
- Department of Dermatology, “Gaetano Rummo” Hospital, Benevento UOC Dermatologia, AO G. Rummo, Benevento, Italy
| | - Carlo Giovanni Carrera
- U.O. Dermatologia, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy
| | - Martina Burlando
- IRCCS San Martino Polyclinic Hospital, Di.S.Sal. Section of Dermatology, Genoa, Italy
| | | | | | - Federico Bardazzi
- Division of Dermatology, University Hospital Policlinico “S. Orsola-Malpighi”, Bologna, Italy
| | - Valeria Brazzelli
- Institute of Dermatology, Foundation IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Paolo Amerio
- Dermatologic Clinic, G. D’Annunzio University, Chieti, Italy
| | - Clara De Simone
- Istituto di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy,Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
| | - Sara Trevisini
- Dermatology Department, University of Trieste, Trieste, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Loconsole
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Catia De Felice
- Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | | | | | | | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Effectiveness and Safety of Secukinumab in Latin American Patients with Moderate to Severe Plaque Psoriasis: PURE Registry 12-Month Data. Dermatol Ther (Heidelb) 2022; 13:269-283. [PMID: 36496547 PMCID: PMC9823177 DOI: 10.1007/s13555-022-00849-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The efficacy and safety of secukinumab in patients with psoriasis has been established in randomised clinical trials. However, data on effectiveness and safety of secukinumab in Latin American real-world settings are scarce. OBJECTIVES To evaluate the effectiveness and safety of secukinumab in real-world settings in patients with psoriasis in Latin America. METHODS PURE is an ongoing multinational, prospective, observational study in patients with moderate-to-severe chronic plaque psoriasis in Canada and Latin America assessing the real-world safety and effectiveness of secukinumab and other approved therapies. The study enrolled (1:1) patients treated with secukinumab versus other approved therapies (other Tx) per local standard of care from 81 community- and hospital-based speciality sites (21 in Latin America). Here, we report effectiveness and safety outcomes with secukinumab and other Tx for plaque psoriasis for up to 12 months in a Latin American population. RESULTS Overall, 187 patients were included in the analysis, 89 of whom initiated secukinumab treatment and 98 of whom received other Tx. At month 12, 84.4%, 71.1% and 53.3% of patients treated with secukinumab achieved Psoriasis Area and Severity Index (PASI) 75/90/100, respectively, compared with 66.7%, 47.9% and 29.2% of patients who received other Tx. Investigator Global Assessment (IGA) 0/1 responders in secukinumab versus other Tx were 78.3% versus 36.7% at month 3 and 81.8% versus 66.7% at month 12, respectively. Overall, the proportion of patients achieving Dermatology Life Quality Index (DLQI) 0/1 improved from 6.9% at baseline to 76.5% at month 12 in patients treated with secukinumab versus 5.6% at baseline to 54.5% at month 12 in patients on other Tx. No unexpected adverse events were reported during the 12-month observation period. CONCLUSION Secukinumab demonstrated real-world effectiveness and improved dermatology quality-of-life in chronic plaque psoriasis patients from Latin America. TRIAL REGISTRATION PURE: NCT02786186.
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Chen XB, Zheng YX, Ye LR, Chen XY, Man XY. Gradually increasing the dosing interval of Secukinumab for moderate to severe plaque psoriasis: A single-center, uncontrolled, prospective study in 36 weeks. Dermatol Ther 2022; 35:e15911. [PMID: 36209377 PMCID: PMC10078391 DOI: 10.1111/dth.15911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022]
Abstract
Secukinumab is a recombinant, fully human monoclonal anti-IL-17A antibody approved to treat moderate-to-severe psoriasis and psoriatic arthritis. Its effectiveness and safety have been confirmed, but a gradual increase in the secukinumab dosing interval has not been investigated. To assess the feasibility, efficacy, and safety of gradually increasing the secukinumab dosing interval; the interval duration was determined by changes in the Psoriasis Area and Severity Index scores. Patients with moderate-to-severe plaque psoriasis received secukinumab 300 mg subcutaneously at baseline and weeks 0, 1, 2, and 3. At week 4, the improvement from baseline PASI guided the next injection time until week 36. In total, 83 patients were recruited. PASI 75 was achieved by 80%, 96%, and 95% of patients at weeks 4, 12, and 36, respectively. PASI 90 was achieved by 54%, 95%, and 84% of patients at weeks 4, 12, and 36, respectively. PASI 100 was achieved by 28%, 89%, and 68% of patients at weeks 4, 12, and 36, respectively. The average PASI score (1.05 ± 1.83) was significantly lower at week 36 than at baseline. Most patients reached PASI 75 at week 36 in our modified study. This study may provide information for future biotherapies.
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Affiliation(s)
- Xi-Bei Chen
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Xin Zheng
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Ran Ye
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue-Yan Chen
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Yong Man
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Chicharro P, Llamas-Velasco M, Armesto S, Herrera Acosta E, Vidal D, Vilarrasa E, Rivera-Diaz R, De-la-Cueva P, Martorell-Calatayud A, Ballescà F, Belinchon I, Carretero G, Rodriguez L, Romero-Maté A, Pujol-Montcusí J, Salgado L, Sahuquillo-Torralba A, Coto-Segura P, Baniandrés Rodríguez O, Feltes R, Riera-Monroig J, Dauden E. Secukinumab is effective and safe in the long-term treatment of plaque psoriasis in a daily practice setting: Multicenter study in 384 Spanish patients. Dermatol Ther 2022; 35:e15929. [PMID: 36223184 DOI: 10.1111/dth.15929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022]
Abstract
The aim of the study was to assess the long-term effectiveness and safety of secukinumab in Spanish patients with moderate-to-severe psoriasis in a daily practice setting. Nationwide multicenter, observational, retrospective, non-interventional, single-cohort study including patients who initiated treatment with secukinumab in daily clinical practice conditions. Subjects were followed for a minimum of 3 months and a maximum of 24 months. Psoriasis Area Severity Index (PASI), Body Surface Area and Physician's Global Assessments were collected at baseline and months 3, 6, 12, 18 and 24 during treatment. Adverse events and reasons for secukinumab withdrawal were collected and classified for analyses. A total of 384 patients were enrolled in the study. Median PASI declined rapidly from 14.3 at baseline to 2.7 at month 3, 2.1 at month 12, and remained low (2.8) at month 24. Within the group of patients with PASI ≥10 at baseline (n = 278), 58.3%, 60.4% and 56.5% achieved a PASI90 response at months 3, 12 and 24, respectively. As for absolute PASI, 86.5%, 69.5%, 42.7% and 37% achieved PASI <5, < 3, < 1 and 0, respectively, at month 3. Secukinumab was more effective in biologic-naïve patients and in those with lower Body Mass Index. Secukinumab presented a good long-term safety profile. Secukinumab was effective and safe in a routine clinical setting, in a large cohort of patients with moderate-to-severe plaque psoriasis, in the short-, medium- and long-term (up to 24 months).
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Affiliation(s)
- Pablo Chicharro
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Susana Armesto
- Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Vidal
- Department of Dermatology, Hospital de Sant Joan Despí Moisés Broggi, Barcelona, Spain
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Raquel Rivera-Diaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo De-la-Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Ferran Ballescà
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - Isabel Belinchon
- Department of Dermatology, Hospital General Universitario de Alicante - ISABIAL, Alicante, Spain
| | - Gregorio Carretero
- Department of Dermatology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Lourdes Rodriguez
- Department of Dermatology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Josep Pujol-Montcusí
- Department of Dermatology, Hospital Universitario de Tarragona "Joan XXIII", Tarragona, Spain
| | - Laura Salgado
- Department of Dermatology, Complejo Hospitalario Universitario, Pontevedra, Spain
| | - Antonio Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitária La Fe, Valencia, Spain
| | - Pablo Coto-Segura
- Department of Dermatology, Hospital Vital Alvarez-Buylla de Mieres, Asturias, Spain
| | | | - Rosa Feltes
- Department of Dermatology, Hospital Universitario la Paz, Madrid, Spain
| | - José Riera-Monroig
- Department of Dermatology, Hospital Clínic i Provincial, Barcelona, Spain
| | - Esteban Dauden
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
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Pellegrini C, Esposito M, Rossi E, Gisondi P, Piaserico S, Dapavo P, Conti A, Gambardella A, Burlando M, Narcisi A, Offidani A, Balestri R, Bardazzi F, Prignano F, Mugheddu C, Romanelli M, Malara G, Schinzari G, Fargnoli MC. Secukinumab in Patients with Psoriasis and a Personal History of Malignancy: A Multicenter Real-Life Observational Study. Dermatol Ther (Heidelb) 2022; 12:2613-2626. [PMID: 36169883 PMCID: PMC9588094 DOI: 10.1007/s13555-022-00797-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction There is limited evidence to guide clinicians on the treatment of psoriasis with biologics in patients with a history of malignancy who are often excluded from clinical trials investigating biologics. The aim of this work is to report a multicenter real-life experience of secukinumab treatment in patients with psoriasis and a personal history of cancer. Methods This retrospective observational study included adult patients with moderate-to-severe plaque psoriasis treated with secukinumab for at least 24 weeks and a previous diagnosis of cancer at 15 Italian referral centers. The primary endpoint of the study was tumor recurrence or progression and new cancer diagnosis during treatment. Secondary outcome assessment of secukinumab effectiveness (reduction of Psoriasis Area and Severity Index [PASI] score, improvement of Dermatology Life Quality Index [DLQI], itch and pain). Results Forty-two patients (27 male) were included. Malignancy was diagnosed in the previous 5 years in 21 (56.8%) and in the previous 10 years in 37 (88.1%). The mean interval between cancer diagnosis and the start of secukinumab treatment was 3.5 ± 3.3 years. No tumor recurrence nor progression occurred over a mean of 56 ± 31.7 weeks of treatment. Three patients developed a new malignancy not related to the previous cancer. At week 48, PASI 90 was reached by 64.7% of patients and PASI 100 by 38.2%. Mean DLQI, itch, and pain VAS scores significantly improved during treatment. Conclusions Our multicenter real-life experience is the largest reported to date focusing on a specific biologic and adds evidence to the safety of secukinumab in psoriatic patients with a personal history of cancer.
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Affiliation(s)
- Cristina Pellegrini
- Dermatology, Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Esposito
- Dermatology, Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ernesto Rossi
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padova, Padua, Italy
| | - Paolo Dapavo
- S.C. Dermatologia U, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Conti
- Dermatologic Unit, Department of General Surgery, Infermi Hospital, Rimini, RN, Italy
- AUSL Romagna, Romagna, Italy
| | - Alessio Gambardella
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di scienze della salute - DISSAL Ospedale Policlinico San Martino, University of Genoa, Genova, Italy
| | - Alessandra Narcisi
- Dermatology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Annamaria Offidani
- Department of Clinical and Molecular Sciences, Dermatology Unit, Polytechnic Marche, University, Ancona, Italy
| | | | - Federico Bardazzi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum, IRCCS Azienda Ospedaliero Universitaria Bologna, University of Bologna, Bologna, Italy
| | - Francesca Prignano
- Department of Health Science, Dermatology Unit, University of Florence, Florence, Italy
| | - Cristina Mugheddu
- Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Giovanna Malara
- Dermatology Department, Grande Ospedale Metropolitano "BMM" Reggio Calabria, Reggio Calabria, Italy
| | - Giovanni Schinzari
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Medical Oncology, Università Cattolica del S. Cuore, Rome, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy
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Thaçi D, Gerdes S, Du Jardin KG, Perrot JL, Puig L. Efficacy of Tildrakizumab Across Different Body Weights in Moderate-to-Severe Psoriasis Over 5 Years: Pooled Analyses from the reSURFACE Pivotal Studies. Dermatol Ther (Heidelb) 2022; 12:2325-2341. [PMID: 36098877 PMCID: PMC9515266 DOI: 10.1007/s13555-022-00793-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Tildrakizumab (TIL), a monoclonal antibody that selectively targets interleukin-23p19, has been approved for the treatment of moderate-to-severe plaque psoriasis. According to the European Medicines Agency Summary of Product Characteristics, the recommended dose is 100 mg, but a 200 mg dose can be used in patients with certain characteristics, such as a high disease burden or body weight (BW) ≥ 90 kg. Fixed one-dose biological therapies tend to become less effective in patients with high BW. This post-hoc study describes the long-term efficacy of TIL across different BWs in pivotal clinical trials. Methods A 5-year pooled analysis of two double-blind, randomised, controlled phase III trials—reSURFACE 1 and 2—was performed. Efficacy measures were the proportions of the patients with an absolute Psoriasis Area and Severity Index (PASI) of < 3 and < 1 and a Dermatology Life Quality Index (DLQI) of 0/1. The study population included patients randomised to TIL 100 mg or TIL 200 mg who received ≥ 1 TIL dose up to week 12 (part 1 of the trial) or up to week 28 (part 2) and patients who were responders (≥ 75% improvement in PASI) to TIL 100 or TIL 200 mg at week 28 and who were maintained on the same dose up to week 244. Efficacy was evaluated by analysing BW subgroups at weeks 28, 52 and 244. Missing data were analysed using multiple imputation. Safety was assessed in the all-patients-as-treated population. Results The proportions of TIL-treated patients with PASI < 3 and < 1 (up to week 244) and DLQI 0/1 (up to week 52) were similar for patients with BW < 90 or ≥ 90 kg, regardless of dose. Patients ≥ 120 kg had greater efficacy outcomes at the 200 mg dose. Safety outcomes were similar regardless of treatment dose and weight (< 120/≥ 120 kg). Conclusion In patients with BW ≥ 120 kg, TIL 200 mg is more efficacious than TIL 100 mg, with similar favourable safety profiles obtained regardless of dose and BW group. Trial registration ClinicalTrials.gov NCT01722331 (reSURFACE 1) and NCT01729754 (reSURFACE 2).
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Affiliation(s)
- Diamant Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Sascha Gerdes
- Department of Dermatology, Venereology and Allergology, Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of St-Etienne, St-Etienne, France
| | - Lluís Puig
- Department of Dermatology, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sermsaksasithorn P, Wongtada C, Chaaim V, Chongpison Y, Asawanonda P. On and off-label uses of interleukin-17 inhibitors for patients with plaque-type psoriasis in Thailand: a real-world study. J DERMATOL TREAT 2022; 33:2963-2974. [PMID: 35695280 DOI: 10.1080/09546634.2022.2089328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Off-label uses of biologics in the treatment of psoriasis are usually implemented in limited-resource settings and studies regarding their response profiles are limited. METHOD This was a retrospective study performed in moderate-to-severe plaque-type psoriasis patients who had been treated with either secukinumab, ixekizumab or brodalumab at a university hospital in Thailand between 1 January 2017 and 1 April 2021. RESULTS A total of 142 patients were included in the data analysis consisting of three groups of 48 patients, 86 patients, and 8 patients treated by secukinumab, ixekizumab, and brodalumab, respectively. Patients were then classified into five groups according to the dosing pattern they received; on-label, off-label with induction, off-label with specific pattern, off-label with irregular dosing interval <8 weeks and >8 weeks. Considering both secukinumab and ixekizumab, the adjusted hazard ratios (95%CI) for complete skin clearance of the four off-label regimens were 2.2(0.9-5.2), 1.9 (0.9-3.9), 1.0 (0.4-2.2), and 1.6 (0.7-3.6), compared to on-label regimen, respectively. In each biologic drug, almost all off-label dosing regimens demonstrated higher adjusted hazard ratios compared to on-label regimen. CONCLUSION Off-label, patient-oriented regimens could be a promising choice of IL-17 inhibitors for administration in special settings. Off-label regimens are not inferior in terms of skin clearance to an on-label regimen in the efficacy of psoriasis treatment of secukinumab and ixekizumab but do cause more flares. The decision to use off-label regimens must account for the benefits and associated risks.
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Affiliation(s)
| | - Chanidapa Wongtada
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Varin Chaaim
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yuda Chongpison
- Faculty of Medicine, Biostatistics Excellence Center, Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - Pravit Asawanonda
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
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Utilization Trends and Impact of Secukinumab Treatment on Clinical Outcomes in Biologic-Naive Patients with Psoriasis in a US Real-World Setting. Dermatol Ther (Heidelb) 2022; 12:1351-1365. [PMID: 35551619 PMCID: PMC9100304 DOI: 10.1007/s13555-022-00740-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/23/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Real-world evidence has demonstrated the effectiveness of secukinumab in the treatment of psoriasis; however, limited data are available on patient profiles of US secukinumab initiators over time and clinical outcomes in biologic-naive patients. This study describes clinical characteristics of secukinumab initiators by year, and the clinical outcomes in patients after 6- and/or 12-month follow-up visits, stratified by prior biologic use. METHODS This observational study included patients enrolled in the CorEvitas (formerly Corrona) Psoriasis Registry. Analyses were conducted in two patient cohorts: (1) all secukinumab initiators, stratified by year, and (2) those who initiated and maintained secukinumab through a 6- and/or 12-month follow-up visit. For all secukinumab initiators, patient characteristics at initiation were described per calendar year; in initiators with follow-up visits, mean (SD) differences in percentage affected body surface area (BSA), five-point Investigator's Global Assessment (IGA), and Psoriasis Area and Severity Index (PASI) scores between baseline and follow-up visits were calculated. Analyses were conducted separately for biologic-naive and biologic-experienced patients. RESULTS Between 2015 and 2020, the proportion of secukinumab initiators in the registry who were biologic-naive increased each year from 12.5% to 49.7%. Overall, 1518 patients initiated secukinumab at or after enrollment; 980 (64.6%) were biologic experienced, and 538 (35.4%) were biologic naive. At 6 months, biologic-experienced and biologic-naive patients reported mean (SD) decreases in BSA (-9.3 [14.5] versus -11.7 [16.6]), IGA (-1.4 [1.3] versus -1.7 [1.4]), and PASI (-5.2 [6.6] versus -6.7 [7.8]). The proportion of patients with an IGA score of clear/almost clear (0/1) increased over fivefold, irrespective of biologic experience. At 12 months, similar improvements were seen. CONCLUSIONS The proportion of biologic-naive secukinumab initiators increased over time. Biologic-naive patients demonstrated similar improvements in clinical outcomes compared with biologic-experienced patients, suggesting that secukinumab may be considered as a first-line therapy for psoriasis.
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13
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Ma VT, Lao CD, Fecher LA, Schiopu E. Successful use of secukinumab in two melanoma patients with immune checkpoint inhibitor-induced inflammatory arthropathy. Immunotherapy 2022; 14:593-598. [PMID: 35416067 DOI: 10.2217/imt-2021-0274] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Immune-related adverse events (irAEs) are a major concern when treating cancer patients with immune checkpoint inhibitor (ICI) therapy. Selecting the most appropriate management of irAEs remains an ongoing challenge because prolonged use of glucocorticoids come with their own side effects and may counteract the antineoplastic effects from immunotherapy. In this case report, we present two patients with metastatic melanoma who developed symptoms of inflammatory arthritis attributed to ICI therapy. We found that treatment with secukinumab, an anti-IL-17A inhibitor, effectively managed their symptoms and did not lead to tumor progression. Our study suggests that secukinumab can be a safe and effective treatment option for ICI-induced inflammatory arthropathy.
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Affiliation(s)
- Vincent T Ma
- Department of Internal Medicine, University of Wisconsin, Division of Hematology, Medical Oncology and Palliative Care, Madison, WI, USA.,Department of Internal Medicine, University of Michigan, Division of Hematology and Oncology, Ann Arbor, MI, USA
| | - Christopher D Lao
- Department of Internal Medicine, University of Michigan, Division of Hematology and Oncology, Ann Arbor, MI, USA
| | - Leslie A Fecher
- Department of Internal Medicine, University of Michigan, Division of Hematology and Oncology, Ann Arbor, MI, USA
| | - Elena Schiopu
- Department of Internal Medicine, University of Michigan, Division of Rheumatology, Ann Arbor, MI, USA
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14
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Messina F, Piaserico S. The dark side of the moon: the immune-mediated adverse events of IL-17A/IL-17R inhibition. J DERMATOL TREAT 2022; 33:2443-2454. [PMID: 35393910 DOI: 10.1080/09546634.2022.2062281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
As aberrant IL-17 signaling plays a critical role in the pathogenesis of psoriasis, biologic agents targeting this pathway have become an important weapon against this disease. Some biologic agents such as IL-17 inhibitors (secukinumab and ixekizumab) and the IL-17 receptor (IL17R) inhibitor (brodalumab) are relatively safe, tolerable and efficacious drugs. Nevertheless, side effects of IL-17 pathway inhibition occur. This review focuses on the dermatological manifestations linked to these treatments. Paradoxical psoriasis and atopic-like eczema may be the most common cutaneous adverse events, while manifestations such as neutrophilic dermatoses, hypersensitivity reactions, lichenoid eruptions, vasculitides, bullous diseases, lupus-like reactions, pigmentation disorders, adnexal diseases and granulomatous dermatoses have been described less frequently.
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Affiliation(s)
- Francesco Messina
- Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
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15
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Sigurgeirsson B, Browning J, Tyring S, Szepietowski JC, Rivera-Díaz R, Effendy I, Keefe D, Bruin G, Paguet B, Fu R, Hampele I, Reinhardt M, Patekar M. Secukinumab demonstrates efficacy, safety and tolerability upon administration by 2 mL autoinjector in adult patients with plaque psoriasis: 52-week results from MATURE, a randomized, placebo-controlled trial. Dermatol Ther 2021; 35:e15285. [PMID: 34954841 DOI: 10.1111/dth.15285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/11/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
Convenient administration is an important factor for treatment adherence in patients with psoriasis. MATURE study reports the efficacy, safety, tolerability, and pharmacokinetics of secukinumab 300 mg 2 mL autoinjector (AI) from MATURE trial (NCT03589885). Eligible patients were randomized to secukinumab 300 mg 2 mL AI or 2x 1 mL pre-filled syringe (PFS) or placebo. The co-primary endpoints were Psoriasis Area and Severity Index (PASI) 75 and Investigator's Global Assessment (IGA) 0/1 response rates at Week 12 versus placebo. Other endpoints included PASI90/100 response, Dermatology Life Quality Index (DLQI) 0/1, pharmacokinetics, 2 mL AI usability rated using Self-Injection Assessment Questionnaire (SIAQ), and safety. The study met both co-primary and secondary endpoints (p < 0.0001). Secukinumab 300 mg 2 mL AI and 2x 1 mL PFS treatments led to superior PASI75/90/100 (2 mL AI: 95.1%/75.6%/43.9%; 2x 1 mL PFS: 83.2%/62.6%/37.5% and placebo: 10%/5.0%/0.0%, respectively), IGA, and DLQI 0/1 responses compared with placebo, and efficacy was sustained through 52 weeks. SIAQ results showed high usability of self-injection with 2 mL AI device. No new safety signals were observed. Study design may bias the interpretation of safety profile after Week 12, due to different exposure of secukinumab versus placebo. Secukinumab 300 mg administered with the 2 mL AI demonstrated superior efficacy over placebo, good tolerability and convenient administration. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bardur Sigurgeirsson
- Faculty of Medicine, Department of Dermatology, University of Iceland, Reykjavík, Iceland
| | | | | | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Isaak Effendy
- Departrment of Dermatology and Allergology, University Hospital of Bielefeld, Germany
| | - Deborah Keefe
- Novartis Pharmaceuticals Corporation, New Jersey, USA
| | - Gerard Bruin
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | | | - Rong Fu
- Novartis Institutes of for Biomedical Research, Shanghai, China
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Use of Biological Treatments in Elderly Patients with Skin Psoriasis in the Real World. Life (Basel) 2021; 11:life11121348. [PMID: 34947880 PMCID: PMC8705752 DOI: 10.3390/life11121348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 12/24/2022] Open
Abstract
Biological drugs have prompted a revolution in the treatment of patients with psoriasis because of their favourable efficacy/risk profile. The aims of our study are to determine whether there is any difference in the pattern of use of biological treatments for older (65+ years) and younger patients diagnosed with plaque psoriasis by the Dermatology Service of the Hospital Universitario de Asturias (HUCA), to understand the survival of these drugs, and to identify the factors that predict the discontinuation of treatments. We report a retrospective observational hospital-based study of 300 patients registered at HUCA’s Dermatology Service who were receiving one of the following biological treatments for psoriasis on 30 November 2020: adalimumab, ustekinumab, secukinumab, or ixekizumab. The age groups were compared using Student’s t-test for quantitative variables and the chi-squared test for qualitative variables. We used the Kaplan–Meier estimator to estimate the survival function and the log-rank test to measure differences. No statistically significant differences in the frequency of use were noted between the younger and older groups, for any of the drugs studied. Survival on a drug regime, globally and individually, was similar in the two age groups. Factors predicting lower overall survival were being female, obesity, and having undergone previous biological treatment. The first three factors were influential in the under-65-year-old group, while arthritis was a significant factor for the older group.
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Colombo D, Bianchi L, Fabbrocini G, Corrao S, Offidani A, Stingeni L, Costanzo A, Pellacani G, Peris K, Bardazzi F, Argenziano G, Ruffolo S, Dapavo P, Carrera C, Fargnoli MC, Parodi A, Romanelli M, Malagoli P, Talamonti M, Megna M, Raspanti M, Paolinelli M, Hansel K, Narcisi A, Conti A, De Simone C, Chessa MA, De Rosa A, Provenzano E, Ortoncelli M, Moltrasio C, Fidanza R, Burlando M, Tonini A, Gaiani FM, Simoni L, Ori A, Fiocchi M, Zagni E. Real-world evidence of biologic treatments in moderate-severe psoriasis in Italy: Results of the CANOVA (EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: An obserVAtional longitudinal study of real-life clinical practice) study. Dermatol Ther 2021; 35:e15166. [PMID: 34676662 DOI: 10.1111/dth.15166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 10/01/2021] [Accepted: 10/15/2021] [Indexed: 12/20/2022]
Abstract
EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: An obserVAtional (CANOVA) study was aimed at providing real-world evidence of the effectiveness of biologics in Italian patients with moderate-severe psoriasis. It was an observational, retro-prospective cohort study conducted in 17 Italian dermatology clinics. Adult patients with moderate-severe plaque psoriasis, who started a biologic treatment between 24 weeks and 24 months before enrolment, were included. With a follow-up visit at 6 months after enrolment, each patient had at least 12 months of observation. The primary objective was to describe the clinical response rates (PASI 75) after 16/24/52 weeks from biologic treatment start. Secondary outcomes were sustained response, quality of life, and treatment satisfaction. Of the 669 eligible patients (64% males), 52% were naïve to biologics, though a mean duration of psoriasis since first diagnosis of 18.6 years (SD 13.2). The most frequently prescribed biologics were secukinumab (41%), ustekinumab (25%), TNF-inhibitors (22%) and ixekizumab (12%). PASI 75 was achieved by 86% of patients (95% CI: 82%-89%) at 16 weeks, 90% (87%-93%) at 24 weeks, and 91% (89%-94%) at 52 weeks. Patients achieving PASI 90 and PASI 100 at 52 weeks were 75% (71%-79%) and 53% (49%-57%), respectively. Sustained PASI 75 response after 1 year from treatment start was achieved by 78% (74%-82%) of patients. Mean DLQI total score was 2.3 (SD 3.9) at enrollment and decreased at the final visit to 1.8 (3.6). A high level of treatment satisfaction was expressed by patients over the study period. This large real-world study confirms in the clinical practice the good effectiveness and acceptability of biologics in psoriasis patients.
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Affiliation(s)
| | - Luca Bianchi
- Dermatology, Policlinico Tor Vergata, Rome, Italy
| | | | | | | | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | - Ketty Peris
- Dermatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS e Università Cattolica, Rome, Italy
| | | | | | - Silvana Ruffolo
- Dermatology, A.O. Cosenza Ospedale SS Annunziata, Cosenza, Italy
| | - Paolo Dapavo
- Dermatology, A.O.U. Città della Salute e della Scienza PO Molinette, Turin, Italy
| | - Carlo Carrera
- Dermatology, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Aurora Parodi
- Dermatology, Clinica Dermatologica DiSSal Università di Genova/Ospedale-Policlinico San Martino IRCCS, Genoa, Italy
| | - Marco Romanelli
- Dermatology, A.O.U. Pisana Ospedale Santa Chiara, Pisa, Italy
| | | | | | | | | | | | - Katharina Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | - Clara De Simone
- Dermatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS e Università Cattolica, Rome, Italy
| | | | - Alina De Rosa
- Dermatology Unit, University of Campania, Naples, Italy
| | | | - Michela Ortoncelli
- Dermatology, A.O.U. Città della Salute e della Scienza PO Molinette, Turin, Italy
| | - Chiara Moltrasio
- Dermatology, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosaria Fidanza
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Martina Burlando
- Dermatology, Clinica Dermatologica DiSSal Università di Genova/Ospedale-Policlinico San Martino IRCCS, Genoa, Italy
| | - Annalisa Tonini
- Dermatology, A.O.U. Pisana Ospedale Santa Chiara, Pisa, Italy
| | | | - Lucia Simoni
- Clinical Data Management and Statistics, MediNeos Observational Research, Modena, Italy
| | - Alessandra Ori
- Clinical Operations, MediNeos Observational Research, Modena, Italy
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Costo per responder di risankizumab e secukinumab nel trattamento della psoriasi a placche da moderata a grave in Italia. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2021; 8:120-130. [PMID: 36627874 PMCID: PMC9616179 DOI: 10.33393/grhta.2021.2258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/18/2021] [Indexed: 01/13/2023] Open
Abstract
Purpose: The objective of this analysis was to compare the cost per responder between risankizumab and secukinumab among patients with moderate-to-severe plaque psoriasis in Italy. Methods: The clinical efficacy was assessed based on IMMerge study of published efficacy data as measured by Psoriasis Area and Severity Index response (PASI 90 and PASI 100) for risankizumab and secukinumab. The treatment cost was based on the number of administrations dispensed in the first (induction plus maintenance period) and the second (maintenance period only) year of treatment and the ex-factory price of each treatment. The cost per responder was adopted as a cost-effectiveness indicator. Results: Independently of the PASI response (PASI 90 and PASI 100) used and the year of treatment considered, the cost per responder was consistently lower for risankizumab compared to secukinumab in all clinical measures. For example, considering the first-year costs and PASI 100, the cost per responder for risankizumab was € 24,506.83 compared to € 38,000.00 for secukinumab. The differences in the cost per responder between risankizumab and secukinumab increased when higher PASI response levels were considered. Conclusion: This economic evaluation suggested that the cost per responder is consistently lower for risankizumab compared to secukinumab from the perspective of the Italian National Health Service in the treatment of moderate-to-severe plaque psoriasis.
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Loft N, Bregnhøj A, Fage S, Nielsen CH, Enevold C, Zachariae C, Iversen L, Skov L. Effectiveness of brodalumab after previous treatment failure of interleukin-17A inhibitors in patients with psoriasis. Dermatol Ther 2021; 34:e15106. [PMID: 34418225 DOI: 10.1111/dth.15106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022]
Abstract
Studies on switch between interleukin (IL)-17 inhibitors are scarce. We assessed the effectiveness of brodalumab in patients with previous treatment failure of IL-17A inhibitor(s). Patients with psoriasis and previous treatment failure of an IL-17A inhibitor were treated with brodalumab at standard dose. Effectiveness was assessed after 12, 26, and 52 weeks of treatment. The primary outcome was the proportion of patients that had achieved an absolute psoriasis area and severity index (PASI) ≤2 and/or a relative reduction of PASI of 75% (PASI75) at week 12. Plasma cytokine levels were measured at baseline and after 12 weeks of treatment. In total, 20 patients were included, seven (35%) were female, the median age was 50 years, and the median baseline PASI was 13.5. Analyzing the data using nonresponder imputation, 14 (70%) patients had achieved either PASI75 and/or PASI ≤2, 8 (40%) had achieved PASI90, and three (15%) had achieved PASI100 at week 12. In total, nine patients (45%) completed the 52-weeks trial and seven patients (35%) still had PASI75 throughout 52 weeks. Seventeen out of 20 patients experienced any adverse events (AEs) during 52 weeks with no serious AEs or deaths. Patients responding to treatment had lower levels of tumor necrosis factor (TNF)-α and IL-6 at baseline compared with those who did not respond to treatment (TNF-α, p = 0.041, IL-6, p = 0.0054). In conclusion, treatment with brodalumab despite previous treatment failure with an IL-17A inhibitor can be effective and well-tolerated.
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Affiliation(s)
- Nikolai Loft
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.,Institute of Clinical Medicine, Aarhus University, Denmark
| | - Simon Fage
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Claus Henrik Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.,Institute of Clinical Medicine, Aarhus University, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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20
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Caron B, Jouzeau JY, Miossec P, Petitpain N, Gillet P, Netter P, Peyrin-Biroulet L. Gastroenterological safety of IL-17 inhibitors: a systematic literature review. Expert Opin Drug Saf 2021; 21:223-239. [PMID: 34304684 DOI: 10.1080/14740338.2021.1960981] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Interleukin 17 is a proinflammatory cytokine considered to play a significant role in the immunopathogenesis of many chronic immune-mediated disorders. Interleukin 17 inhibitors provide an excellent treatment option for patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis. However, Interleukin 17 inhibitors have been suspected of worsening or triggering new-onset inflammatory bowel disease. AREAS COVERED A literature search was conducted until March 2021 to investigate reporting prevalence, and characteristics of all gastroenterological adverse events in patients treated with Interleukin 17 inhibitors. One hundred and six clinical randomized trials were included, involving 40,053 patients. Inflammatory bowel disease cases were reported in 0.4% of patients exposed to Interleukin 17 inhibitors. The most frequent other gastrointestinal adverse events were diarrhea (2.5%), nausea or vomiting (0.7%), and gastroenteritis (0.2%). Sixty-one uncontrolled or retrospective studies were included, involving 16,791 patients. Sixty (0.36%) inflammatory bowel disease cases were reported, 0.6% of patients reported other gastrointestinal adverse events. EXPERT OPINION Interleukin 17 inhibitors are safe and effective in the treatment of psoriasis, psoriatic arthritis, and ankylosing spondylitis. Low incidence rate of developing new-onset inflammatory bowel disease or exacerbating preexisting inflammatory bowel disease with anti-IL-17 agents has been reported. Clinicians should be aware of the possibility of these concerns when considering this therapy.
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Affiliation(s)
- Bénédicte Caron
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Jean-Yves Jouzeau
- Department of Clinical Pharmacology and Toxicology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Pierre Miossec
- Department of Clinical Immunology and Rheumatology and the Immunogenomics and Inflammation Research Unit, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Nadine Petitpain
- Department of Clinical Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Pierre Gillet
- Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,Department of Clinical Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Patrick Netter
- Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
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21
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Secukinumab for the treatment of psoriasis, psoriatic arthritis, and axial spondyloarthritis: Physical and pharmacological properties underlie the observed clinical efficacy and safety. Pharmacol Ther 2021; 229:107925. [PMID: 34171337 DOI: 10.1016/j.pharmthera.2021.107925] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022]
Abstract
Psoriasis, psoriatic arthritis, and axial spondyloarthritis are systemic inflammatory diseases, each commonly manifesting as a spectrum of symptoms, complications, and comorbidities that arise differently in individual patients. Drugs targeting inflammatory cytokines common to the pathogenesis of each of these conditions have been developed, although their specific actions in the different tissues involved are variable. For a drug to be effective, it must be efficiently delivered to and locally bioactive in disease-relevant tissues. Detailed clinical data shed light on the therapeutic effects of individual biologics on specific domains or clinical manifestations of disease and assist in guiding treatment decisions. Pharmacologic, molecular, and functional properties of drugs strongly impact their observed safety and efficacy, and an understanding of these properties provides complementary insight. Secukinumab, a fully human monoclonal IgG1/κ antibody selectively targeting interleukin (IL)-17A, has been in clinical use for >6 years in the treatment of moderate to severe psoriasis, psoriatic arthritis, and both radiographic (also known as ankylosing spondylitis) and nonradiographic axial spondyloarthritis. In this review, we discuss pharmacokinetic and pharmacodynamic data for secukinumab to introduce clinicians to the pharmacological properties of this widely used drug. Understanding how these properties affect the observed clinical efficacy, safety, and tolerability of this drug in the treatment of IL-17A-mediated systemic inflammatory diseases is important for all physicians treating these conditions.
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22
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The Association of Psoriasis and Obesity: Focusing on IL-17A-Related Immunological Mechanisms. INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2021. [DOI: 10.1097/jd9.0000000000000155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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23
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Lebwohl M, Deodhar A, Griffiths CEM, Menter MA, Poddubnyy D, Bao W, Jehl V, Marfo K, Primatesta P, Shete A, Trivedi V, Mease PJ. The risk of malignancy in patients with secukinumab-treated psoriasis, psoriatic arthritis and ankylosing spondylitis: analysis of clinical trial and postmarketing surveillance data with up to five years of follow-up. Br J Dermatol 2021; 185:935-944. [PMID: 33829482 DOI: 10.1111/bjd.20136] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on the use of biologic therapy and malignancy risk are inconsistent due to limited long-term robust studies. OBJECTIVES To assess the malignancy risk in patients with secukinumab-treated psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS). METHODS This integrated safety analysis from both the secukinumab clinical trial programme and postmarketing safety surveillance data included any patient receiving at least one approved dose of secukinumab with a maximum of 5 years of follow-up. Safety analyses evaluated the rate of malignancy using exposure-adjusted incidence rates [EAIR; incidence rates per 100 patient treatment-years (PTY)]. Standardized incidence ratios (SIRs) were reported using the Surveillance, Epidemiology, and End Results Program (SEER) database as a reference population. Crude incidence of malignancy was also reported using postmarketing surveillance data. RESULTS Safety data from 49 clinical trials with secukinumab-treated patients were included: 10 685 patients with psoriasis, 2523 with PsA and 1311 with AS. Across indications over a 5-year period, the EAIR of malignancy was 0·85 per 100 PTY [95% confidence interval (CI) 0·74-0·98] in secukinumab-treated patients, corresponding to 204 patients per 23 908 PTY. Overall, the observed vs. expected number of malignancies from secukinumab clinical trial data were comparable, as indicated by an SIR of 0·99 (95% CI 0·82-1·19) across indications. The estimated crude cumulative incidence reporting rate per 100 PTY for malignancy was 0·27 in the postmarketing surveillance data across indications with a cumulative exposure of 285 811 PTY. CONCLUSIONS In this large safety analysis, the risk of malignancy was low for up to 5 years of secukinumab treatment. These data support the long-term use of secukinumab in these indications.
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Affiliation(s)
- M Lebwohl
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - A Deodhar
- Oregon Health & Science University, Portland, OR, USA
| | - C E M Griffiths
- The Dermatology Centre, The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - M A Menter
- Division of Dermatology, Baylor Scott & White Health, Dallas, TX, USA
| | - D Poddubnyy
- Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité, Universitätsmedizin Berlin, Germany, and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany
| | - W Bao
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - V Jehl
- Novartis Pharma AG, Basel, Switzerland
| | - K Marfo
- Novartis Pharma AG, Basel, Switzerland
| | | | - A Shete
- Novartis Pharma AG, Basel, Switzerland
| | - V Trivedi
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - P J Mease
- Department of Rheumatology, Swedish Health Services/Providence St Joseph Health and University of Washington, Seattle, WA, USA
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24
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Ghoreschi K, Balato A, Enerbäck C, Sabat R. Therapeutics targeting the IL-23 and IL-17 pathway in psoriasis. Lancet 2021; 397:754-766. [PMID: 33515492 DOI: 10.1016/s0140-6736(21)00184-7] [Citation(s) in RCA: 219] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 04/09/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory disease characterised by sharply demarcated erythematous and scaly skin lesions accompanied by systemic manifestations. Classified by WHO as one of the most serious non-infectious diseases, psoriasis affects 2-3% of the global population. Mechanistically, psoriatic lesions result from hyperproliferation and disturbed differentiation of epidermal keratinocytes that are provoked by immune mediators of the IL-23 and IL-17 pathway. Translational immunology has had impressive success in understanding and controlling psoriasis. Psoriasis is the first disease to have been successfully treated with therapeutics that directly block the action of the cytokines of this pathway; in fact, therapeutics that specifically target IL-23, IL-17, and IL-17RA are approved for clinical use and show excellent efficacy. Furthermore, inhibitors of IL-23 and IL-17 intracellular signalling, such as TYK2 or RORγt, are in clinical development. Although therapies that target the IL-23 and IL-17 pathway also improve psoriatic arthritis symptoms, their effects on long-term disease modification and psoriasis-associated comorbidities still need to be explored.
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Affiliation(s)
- Kamran Ghoreschi
- Department of Dermatology, Venereology, and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany; Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Anna Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Charlotta Enerbäck
- Ingrid Asp Psoriasis Research Center, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Robert Sabat
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Charité-Universitätsmedizin Berlin, Berlin, Germany
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25
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Ferreira P, Mendes-Bastos P. Secukinumab: A complete approach to psoriatic patients-Real-world evidence study. Dermatol Ther 2021; 34:e14815. [PMID: 33497528 DOI: 10.1111/dth.14815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/07/2021] [Accepted: 01/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Paulo Ferreira
- Psoriasis Clinic, Dermatology Center, Hospital CUF Descobertas, Lisbon, Portugal
| | - Pedro Mendes-Bastos
- Psoriasis Clinic, Dermatology Center, Hospital CUF Descobertas, Lisbon, Portugal
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26
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Three years of methotrexate and secukinumab: Outcomes of psoriatic arthritis in a real-life setting. J Am Acad Dermatol 2021; 86:241-243. [PMID: 33549655 DOI: 10.1016/j.jaad.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 11/20/2022]
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27
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Ceccarelli M, Venanzi Rullo E, Berretta M, Cacopardo B, Pellicanò GF, Nunnari G, Guarneri C. New generation biologics for the treatment of psoriasis and psoriatic arthritis. State of the art and considerations about the risk of infection. Dermatol Ther 2020; 34:e14660. [PMID: 33301216 DOI: 10.1111/dth.14660] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic immune-mediated disease characterized by inflammation of skin (psoriasis) or joints (psoriatic arthritis) or both, resulting from a dysregulation in particular of the T helper (Th)17 functions. There is no available cure for psoriasis, and a life-long treatment is needed to control signs and symptoms. Research interest is high around the newest biological drugs approved for the treatment of moderate to severe psoriasis and psoriatic arthritis, and especially drugs blocking the IL-23/IL-17 axis. Our aim is to review the new biological drugs for the treatment of psoriasis and their adverse effects, focusing on the risk of infections.
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Affiliation(s)
- Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimiliano Berretta
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Bruno Cacopardo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
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28
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Bonifati C, Morrone A, Cristaudo A, Graceffa D. Effectiveness of anti-interleukin 23 biologic drugs in psoriasis patients who failed anti-interleukin 17 regimens. A real-life experience. Dermatol Ther 2020; 34:e14584. [PMID: 33236471 DOI: 10.1111/dth.14584] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 12/29/2022]
Abstract
Among the most recent biologic drugs available for psoriasis therapy, those targeting interleukin-17 (secukinumab and ixekizumab) or its receptor (brodalumab) have been shown to be quickly effective. However, in those patients who failed one or more of the above-cited drugs, real-life data on the effectiveness of switching to one anti-interleukin-23 biologic (guselkumab, risankizumab, or tildrakizumab) are very scarce. Here, we report our experience in treating 12 multi-failure psoriatic patients, prospectively followed-up over 6 months, who showed a significant improvement in their psoriasis after switching from an anti-interleukn-17 to an anti-interleukin-23 drug.
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Affiliation(s)
- Claudio Bonifati
- Department of Clinical Dermatology; Center for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonio Cristaudo
- Department of Clinical Dermatology; Center for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Dario Graceffa
- Department of Clinical Dermatology; Center for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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29
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Yıldırım FE, Hapa FA. Clinical efficacy and safety of secukinumab for psoriasis in a real-world setting in Turkey. J DERMATOL TREAT 2020; 33:1531-1537. [DOI: 10.1080/09546634.2020.1839009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Fatma Elif Yıldırım
- Faculty of Medicine Department of Dermatology, Sanko University, Gaziantep, Turkey
| | - Fatma Aslı Hapa
- Dermatology Clinic, Doctor Suat Seren Training and Research Hospital, Izmir, Turkey
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30
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Megna M, Fabbrocini G, Ferrillo M, Cinelli E. Erythrodermic psoriasis successfully and rapidly treated with brodalumab: Report of two cases. Dermatol Ther 2020; 33:e14351. [PMID: 32981222 DOI: 10.1111/dth.14351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 01/26/2023]
Abstract
Erythrodermic psoriasis (EP) is a rare form of the disease clinically characterized by a generalized erythema covering ≥90% of the body surface area (BSA). The management of EP is challenging: no standardized guidelines exist with literature suggesting cyclosporine or infliximab as first-line therapy. However, a recent systematic review showed a positive response in EP patients treated with biologic agents. The most common biologic used for EP up until now has been ustekinumab, whereas infliximab might represent a first-line option in case of complicated EP (acute, severe, or unstable). Up until now, no case of brodalumab (a monoclonal antibody blocking IL-17 receptor) treatment for EP in real-life has ever been described. Here, we report the first two cases of efficacy and safety of brodalumab in real-life cases of EP.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II0, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II0, Naples, Italy
| | - Maria Ferrillo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II0, Naples, Italy
| | - Eleonora Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II0, Naples, Italy
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31
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Rodríguez-Cerdeira C, González-Cespón JL, Martínez-Herrera E, Carnero-Gregorio M, López-Barcenas A, Sergeev A, Saunte DM. Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. Ital J Dermatol Venerol 2020; 156:545-557. [PMID: 33026212 DOI: 10.23736/s2784-8671.20.06580-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Interleukin 17A (IL-17A) is a pro-inflammatory cytokine produced by helper T cells (Th17) and other cells of the immune system and exerts pleiotropic effects on multiple cell lines. The role of IL-17 in the pathogenesis of numerous inflammatory disorders is well-documented. IL-17 activates signaling through the IL-17 receptor, which induces other proinflammatory cytokines, antimicrobial peptides, and neutrophil chemokines that are important for antifungal activity. EVIDENCE ACQUISITION Healthy levels of IL-17 can protect the host against extracellular bacterial and fungal infections in mucous membranes and epithelia. IL-17 deficiency reduces control of certain infections, while excessive IL-17 can produce unwanted inflammatory effects. EVIDENCE SYNTHESIS Although the efficacy of the therapeutic blockade of this cytokine has been proven in several autoimmune diseases such as psoriasis and psoriatic arthritis, this strategy could also exacerbate fungal infections in such patients. Therefore, a better understanding of IL-17-mediated immunity to Candida is necessary for the development of autoimmune therapeutics that maintain antifungal immunity. CONCLUSIONS In this review, we include a study of the new anti-IL-17 biological agents (secukinumab, ixekizumab, and bromalizumab) used for moderate-to-severe psoriasis and psoriatic arthritis treatment in clinical practice, as well as pivotal trials with bimekizumab. We study the relationship of these biological agents and the appearance of candidiasis in its various clinical forms.
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Affiliation(s)
- Carmen Rodríguez-Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute SERGAS-UVIGO, Vigo, Spain - .,Department of Dermatology, Hospital do Meixoeiro, University of Vigo, Vigo, Spain - .,Psychodermatology Task Force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina - .,European Academy of Dermatology and Venereology (EADV), Lugan, Switzerland -
| | - José L González-Cespón
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute SERGAS-UVIGO, Vigo, Spain
| | - Erick Martínez-Herrera
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute SERGAS-UVIGO, Vigo, Spain.,Psychodermatology Task Force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina
| | - Miguel Carnero-Gregorio
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute SERGAS-UVIGO, Vigo, Spain.,Department of Molecular Diagnosis (Array and NGS Division), Institute of Cellular and Molecular Studies - ICM, Lugo, Spain
| | | | - Alexey Sergeev
- European Academy of Dermatology and Venereology (EADV), Lugan, Switzerland.,Central Research Dermatology Clinic Dmitrovskoe, Moscow, Russia
| | - Ditte M Saunte
- European Academy of Dermatology and Venereology (EADV), Lugan, Switzerland.,Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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32
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Carpentieri A, Mascia P, Fornaro M, Beylot‐Barry M, Taieb A, Foti C, Loconsole F. Effectiveness and safety of secukinumab in patients with moderate‐severe psoriasis: A multicenter real‐life study. Dermatol Ther 2020; 33:e14044. [DOI: 10.1111/dth.14044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 07/18/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Antonio Carpentieri
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology University of Bari Bari Italy
| | - Paola Mascia
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology University of Bari Bari Italy
| | - Marco Fornaro
- Department of Emergency and Organ Transplantation‐Rheumatology Unit University of Bari Bari Italy
| | - Marie Beylot‐Barry
- Department of Dermatology, Oncodermatology and Interventional Dermatology Bordeaux University Hospital Bordeaux France
| | - Alain Taieb
- Department of Dermatology, Oncodermatology and Interventional Dermatology Bordeaux University Hospital Bordeaux France
| | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology University of Bari Bari Italy
| | - Francesco Loconsole
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology University of Bari Bari Italy
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33
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Wang HN, Huang YH. Changes in metabolic parameters in psoriatic patients treated with secukinumab. Ther Adv Chronic Dis 2020; 11:2040622320944777. [PMID: 32821362 PMCID: PMC7412909 DOI: 10.1177/2040622320944777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/26/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Psoriasis is associated with cardiovascular disease and metabolic syndrome but the effects of interleukin (IL)-17A inhibitor treatment on metabolic parameters are unknown. This study aimed to determine the effects of secukinumab on metabolic parameters based on the disease activity and treatment response in patients with psoriasis. Methods: In this retrospective study, we included 99 patients with moderate to severe psoriasis, who received IL-17 inhibitor (secukinumab) treatment for 24 weeks between January 2016 and February 2020. The disease activity [Psoriasis Area and Severity Index (PASI)] and metabolic parameters at baseline and after 12 or 24 weeks of treatment were collected. Results: The PASI improved with a significant reduction of high-sensitivity C-reactive protein (hs-CRP) at weeks 12 and 24 respectively. However, body weight and body mass index were significantly increased at week 12 and 24 of treatment. Triglycerides level and atherogenic index of plasma were significantly higher in week 24 in PASI-90 non-responders. The baseline hs-CRP level and PASI-90 non-response correlated with elevated triglyceride levels. Conclusion: Our results suggest that obesity and hypertriglyceridemia still existed in patients despite the improved disease activity after secukinumab treatment. Higher baseline hs-CRP level and PASI-90 non-response were predictors for elevated triglyceride levels after treatment. Therefore, patient education, regular screening of the lipid profile, and weight control are recommended during the treatment of secukinumab.
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Affiliation(s)
- Hsuan Ning Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taiwan
| | - Yu Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
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Loft N, Halling AS, Egeberg A, Skov L. Efficacy of a second interleukin 17 inhibitor in patients with psoriasis: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 84:130-138. [PMID: 32730851 DOI: 10.1016/j.jaad.2020.07.085] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multiple biologics for psoriasis exist, and interleukin (IL) 17 inhibitors are among those with the best efficacy. However, switching treatment is often required at some point, and intraclass switch of IL-17 inhibitors is not well investigated. OBJECTIVES To determine the efficacy of a second IL-17 inhibitor in patients with psoriasis. METHODS Two authors independently searched the databases PubMed and EMBASE for studies reporting on efficacy of IL-17 inhibitors in patients with psoriasis previously exposed to another IL-17 inhibitor. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In total, 14 publications comprising 655 patients were included. The proportion of patients achieving a reduction of 75%, 90%, and 100% in Psoriasis Area Severity Index were, respectively, 74.6 (95% confidence interval [CI], 63.9-84.0), 69.4% (95% CI, 53.2-83.4), and 46.4 (95% CI, 30.5-62.7) after short-term treatment (weeks 9, 12, and 16 combined). LIMITATIONS Most studies included were on ixekizumab and were retrospective chart reviews with no information on the response to the previous IL-17 inhibitor. CONCLUSION Previous treatment with an IL-17 inhibitor does not appear to affect the efficacy of another IL-17 inhibitor in the treatment of psoriasis. However, further prospective studies are needed.
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Affiliation(s)
- Nikolai Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
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Wu JJ, Merola JF, Feldman SR, Menter A, Lebwohl M. Treatment of Psoriasis with Secukinumab in Challenging Patient Scenarios: A Review of the Available Evidence. Dermatol Ther (Heidelb) 2020; 10:351-364. [PMID: 32242325 PMCID: PMC7211772 DOI: 10.1007/s13555-020-00373-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Indexed: 01/06/2023] Open
Abstract
Psoriasis (PsO) is a common, systemic, chronic, inflammatory disease characterized by key clinical symptoms, including itching, pain, and scaling. PsO is associated with a high prevalence of comorbidities, including other autoimmune diseases and malignancies. Furthermore, special populations, such as pregnant, pediatric, and elderly patients, and those with erythrodermic PsO, are challenging to treat and require tightly monitored disease and treatment management. Because certain populations have demographic or clinical characteristics that can affect the presentation of PsO and complicate treatment responses, these patient populations are largely excluded from clinical trials; therefore, most clinical evidence for the treatment of these patients is derived from case reports and series. Secukinumab, a fully human monoclonal interleukin-17A antibody, has been shown in several clinical trials to be effective and safe for the treatment of PsO; however, these studies offer only limited data on the use of secukinumab in patients with chronic illnesses or in special populations. This review explores the use of secukinumab for PsO in special populations, including pregnant women, children, elderly people, patients with erythrodermic PsO, and those with chronic illnesses, including latent tuberculosis, hepatitis B and C, HIV, multiple sclerosis, and malignancies.
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Affiliation(s)
- Jashin J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA.
| | - Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alan Menter
- Baylor Scott & White Health, Dallas, TX, USA
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Rompoti N, Sidiropoulou P, Panagakis P, Stratigos A, Papoutsaki M, Stefanaki E, Vavouli C, Politou M, Befon A, Kostakis P, Rigopoulos D, Nicolaidou E. Real‐world data from a single Greek centre on the use of secukinumab in plaque psoriasis: effectiveness, safety, drug survival, and identification of patients that sustain optimal response. J Eur Acad Dermatol Venereol 2020; 34:1240-1247. [DOI: 10.1111/jdv.16202] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Affiliation(s)
- N. Rompoti
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - P. Sidiropoulou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - P. Panagakis
- State Department of Dermatology‐Venereology “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - A. Stratigos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - M. Papoutsaki
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - E. Stefanaki
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - C. Vavouli
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - M. Politou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - A. Befon
- State Department of Dermatology‐Venereology “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - P. Kostakis
- State Department of Dermatology‐Venereology “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - D. Rigopoulos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
| | - E. Nicolaidou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens “A. Sygros” Hospital for Skin and Venereal Diseases Athens Greece
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Augustin M, Jullien D, Martin A, Peralta C. Real-world evidence of secukinumab in psoriasis treatment - a meta-analysis of 43 studies. J Eur Acad Dermatol Venereol 2020; 34:1174-1185. [PMID: 31919937 DOI: 10.1111/jdv.16180] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023]
Abstract
Real-world evidence (RWE) meta-analyses provide valuable insights from patients in routine clinical practice. Secukinumab, the first fully human monoclonal antibody that neutralizes IL-17A, has shown long-lasting effectiveness and safety in plaque psoriasis (PsO). Since its licence approval in 2015, many RWE studies have been published. The objective of this study was to review all available literature on RWE studies with secukinumab and the secukinumab arm of comparator studies in patients with moderate-to-severe PsO to evaluate its effectiveness, drug survival and safety. https://www.embase.com and https://clinicaltrials.gov databases were searched using prespecified inclusion criteria between 1 January 2015 and 31 May 2019. Using a meta-package and R statistical software to analyse data, key outcomes were measured at 3, 6 and 12 months. PASI and DLQI score data were recorded for patients who remained on secukinumab treatment. Overall, 43 studies were included. Drug survival was 90% at 3 and 6 months, and 80% at 12 months. At 12 months, 8% of patients had discontinued treatment due to lack of effectiveness. At 3, 6 and 12 months, Psoriasis Area and Severity Index (PASI) 90 scores were as follows: 50%, 53% and 60%, and PASI 100 scores were 36%, 46% and 51%, respectively. At 3, 6 and 12 months, 57%, 55% and 65% of patients achieved a Dermatology Life Quality Index (DLQI) score of 0 or 1, respectively. Adverse events were consistent with rates observed in clinical trials with no new safety signals. This meta-analysis strengthens existing evidence on the clinical effectiveness of secukinumab in patients with moderate-to-severe PsO, demonstrating high drug survival rates, high levels of patient-reported outcomes, and good tolerance.
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Affiliation(s)
- M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - D Jullien
- Department of Dermatology, Faculty of Medicine, Hôpital Edouard Herriot, University of Lyon, Lyon, France
| | - A Martin
- Novartis Pharma AG, Basel, Switzerland
| | - C Peralta
- Novartis Pharma AG, Basel, Switzerland
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Reich K, Warren R, Coates L, Di Comite G. Long‐term efficacy and safety of secukinumab in the treatment of the multiple manifestations of psoriatic disease. J Eur Acad Dermatol Venereol 2020; 34:1161-1173. [DOI: 10.1111/jdv.16124] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/19/2019] [Indexed: 12/12/2022]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
- Skinflammation® Center Hamburg Germany
- Dermatologikum Berlin Berlin Germany
| | - R.B. Warren
- Dermatology Centre Salford Royal NHS Foundation Trust Manchester NIHR Biomedical Research Centre Manchester Academic Health Science Centre The University of Manchester Manchester UK
| | - L.C. Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
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Chiricozzi A, Balato A, Conrad C, Conti A, Dapavo P, Ferreira P, Gaiani FM, Leite L, Malagoli P, Mendes-Bastos P, Megna M, Messina F, Nidegger A, Odorici G, Panduri S, Piaserico S, Piscitelli L, Prignano F, Ribero S, Valerio J, Torres T. Secukinumab demonstrates improvements in absolute and relative psoriasis area severity indices in moderate-to-severe plaque psoriasis: results from a European, multicentric, retrospective, real-world study. J DERMATOL TREAT 2019; 31:476-483. [DOI: 10.1080/09546634.2019.1671577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Anna Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Curdin Conrad
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - Andrea Conti
- Dermatology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Paolo Dapavo
- Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | | | | | | | | | | | - Matteo Megna
- Department of Dermatology, University of Naples Federico II, Napoli, Italy
| | | | - Alessia Nidegger
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - Giulia Odorici
- Dermatology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | | | | | | | | | - Simone Ribero
- Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
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D’Adamio S, Silvaggio D, Lombardo P, Bianchi L, Talamonti M, Galluzzo M. The safety of anti-interleukins monoclonal antibodies for the treatment of psoriasis. Expert Opin Drug Saf 2019; 18:1031-1041. [DOI: 10.1080/14740338.2019.1663168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- S. D’Adamio
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - D. Silvaggio
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - P. Lombardo
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - L. Bianchi
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Talamonti
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Galluzzo
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
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