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Papp KA, Gooderham M, Lynde C, Brassard D, Al-Mohammedi F, Prajapati VH, Delorme I, Albrecht L, Haydey R, Alam MS, Beecker J, Siddha S, Maguin M, Farag MS, Vieira A, Rihakova L, Langley RG. Effectiveness and safety of secukinumab updosing in patients with moderate to severe plaque psoriasis: data from the PURE registry. Arch Dermatol Res 2024; 316:362. [PMID: 38850346 PMCID: PMC11162361 DOI: 10.1007/s00403-024-03122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 03/28/2024] [Accepted: 04/26/2024] [Indexed: 06/10/2024]
Abstract
Secukinumab is a fully human IgG1 antibody that selectively binds to and neutralizes the proinflammatory cytokine interleukin-17A. Secukinumab is an effective and well-tolerated treatment for plaque psoriasis. There is a limited real-word evidence for dose optimisation of secukinumab based on clinical response. PURE is a multi-national, 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 indicated therapies. The aim of the current snapshot analysis was to evaluate the effectiveness and safety of on-label dose and updosed secukinumab in patients with plaque psoriasis enrolled in the PURE study. At the time of analysis, 676 patients received secukinumab, of which 84.6% (n = 572) remained on the on-label dose, while 15.4% (n = 104) were updosed. With on-label secukinumab, the absolute Psoriasis Area and Severity Index (PASI) score was reduced from 13.6 at baseline to 1.2 over 36 months, with treatment persistence of 73% at 40 months. At Month 36, 73.2% of the patients receiving on-label secukinumab achieved Investigator's Global Assessment (IGA) 0/1. With updosed secukinumab (300 mg every 2 weeks, 300 mg every 3 weeks, 450 mg every 4 weeks, or 450 mg every 3 weeks), 57.9% of the patients showed improvement in the absolute PASI score at the first visit after updosing, with treatment persistence of 50% at 12 months after updosing. At Month 15, 40% of patients receiving updosed secukinumab achieved IGA 0/1. Patients with previous biologic exposure (odds ratio [OR]: 3.25; 95% confidence interval [CI]: 2.03, 5.18, p < 0.0001) were more likely to be updosed while those with a body weight < 90 kg (OR: 0.49; 95% CI [0.31, 0.77], p = 0.0019) were less likely to be updosed. Previous biologic exposure (HR [hazard ratio]: 1.47; 95% CI [1.24, 1.75], p < 0.0001) and current biologic exposure (secukinumab vs. other indicated therapies: HR 0.57; 95% CI [0.43, 0.75], p = 0.0001) were significantly associated with time to secukinumab updosing. No new or unexpected safety signals were observed with updosed secukinumab. Secukinumab updosing was efficacious and well-tolerated in patients with psoriasis who failed to respond to the approved on-label regimen, suggesting that updosing may be a useful therapeutic option for approved dose non-responders.
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Affiliation(s)
- Kim A Papp
- Alliance Clinical Trials and Probity Medical Research, Waterloo, ON, Canada.
- The University of Toronto, Toronto, ON, Canada.
| | - Melinda Gooderham
- SKiN Center for Dermatology, Queen's University and Probity Medical Research, Peterborough, ON, Canada
| | - Charles Lynde
- Lynde Institute for Dermatology, University of Toronto and Probity Medical Research, Markham, ON, Canada
| | | | | | - Vimal H Prajapati
- Division of Community Pediatrics and Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Isabelle Delorme
- Dermatology Research Institute and Probity Medical Research, Calgary, AB, Canada
- Skin Health & Wellness Centre, Calgary, AB, Canada
| | | | - Richard Haydey
- Enverus Medical Research, University of British Columbia and Probity Medical Research, Surrey, BC, Canada
| | | | - Jennifer Beecker
- Simcoderm Medical and Surgical Dermatology Centre and Probity Medical Research, Barrie, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
| | - Sanjay Siddha
- Division of Dermatology, The Ottawa Hospital, Ottawa Hospital Research Institute and Probity Medical Research, Ottawa, ON, Canada
| | - Marie Maguin
- Probity Medical Research, Division of Dermatology, University Health Network Hospitals, Toronto, ON, Canada
| | | | | | | | - Richard G Langley
- Division of Clinical Dermatology & Cutaneous Science, Department of Medicine, Halifax, Canada
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Armstrong A, González-Cantero A, Khattri S, Muzy G, Malatestinic WN, Lampropoulou A, Feely M, See SK, Mert C, Blauvelt A. Comparing Achievement of National Psoriasis Foundation Treatment Targets among Patients with Plaque Psoriasis Treated with Ixekizumab versus Other Biologics in Clinical and Real-World Studies. Dermatol Ther (Heidelb) 2024; 14:933-952. [PMID: 38521874 PMCID: PMC11052751 DOI: 10.1007/s13555-024-01136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION The National Psoriasis Foundation (NPF) recommends evaluating patient response to treatment at week 12, with a target response of ≤ 1% body surface area (BSA) affected by plaque psoriasis and an acceptable response of BSA ≤ 3% or ≥ 75% improvement. This post hoc analysis compared the achievement of NPF target and acceptable responses for ixekizumab (IXE) versus other biologics. METHODS Outcomes were evaluated at week 12 for patients with moderate-to-severe plaque psoriasis from four head-to-head randomized clinical trials (RCTs; UNCOVER-2, UNCOVER-3, IXORA-R, and IXORA-S) and one real-world prospective observational study (Psoriasis Study of Health Outcomes; PSoHO). RCT patients were treated with IXE or etanercept (ETN; UNCOVER-2/3), guselkumab (GUS; IXORA-R), or ustekinumab (UST; IXORA-S). PSoHO patients were treated with anti-interleukin (IL)-17A biologics (IXE, secukinumab, SEC) and other approved biologics for the treatment of plaque psoriasis. Patients with missing outcomes were imputed as non-responder imputation. For RCT data, statistical comparisons between treatment groups were performed using Fisher's exact test with no multiplicity adjustments. For real-world data, adjusted comparative analyses were performed using frequentist model averaging (FMA) and reported as odds ratio (OR). RESULTS Across the four head-to-head clinical trials analyzed, significantly higher proportions of patients achieved target and acceptable responses at week 12 with IXE versus ETN, GUS, or UST. Likewise, the proportion of PSoHO patients achieving target and acceptable response at week 12 was higher with IXE compared with other individual biologics. Adjusted comparative analyses showed that IXE had significantly greater odds of target and acceptable response at week 12 versus SEC, GUS, risankizumab (RIS), adalimumab (ADA), UST, and tildrakizumab (TILD) and numerically greater odds of target and acceptable response at week 12 versus brodalumab (BROD). CONCLUSION Across both clinical studies and real-world settings, more patients treated with IXE achieved NPF target and acceptable responses at week 12 compared with those treated with other biologics. TRIAL REGISTRATION UNCOVER-2 (NCT01597245); UNCOVER-3 (NCT01646177); IXORA-R (NCT03573323); IXORA-S (NCT02561806); PSoHO (EUPAS24207).
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Affiliation(s)
| | - Alvaro González-Cantero
- Ramón y Cajal University Hospital, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | | | | | - Meghan Feely
- Mount Sinai Hospital, New York, NY, USA
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Can Mert
- HaaPACS GmbH, Schriesheim, Germany
| | - Andrew Blauvelt
- Oregon Medical Research Center, 9495 SW Locust St., Suite G, Portland, OR, 97223, USA.
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Hsieh CY, Tseng YH, Tsai TF. Predictors for the effectiveness of 75 mg risankizumab in treating psoriasis-A real-word evidence from a 52-week retrospective study. Exp Dermatol 2023; 32:2138-2148. [PMID: 37864438 DOI: 10.1111/exd.14963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/22/2023]
Abstract
In the registration trial of risankizumab for patients with moderate-to-severe psoriasis in Japan, similar Psoriasis Area Severity Index (PASI) responses were observed for 75 mg or 150 mg risankizumab at most time points up to 52 weeks, except for PASI 100 at week 16. The use of 75 mg risankizumab offers an attractive option considering the high cost of risankizumab. However, it is unknown whether patients with mild-to-moderate psoriasis respond similarly, and the efficacy data of non-Japanese patients is also lacking. We retrospectively included 30 consecutive Chinese patients receiving half-dose (75 mg) risankizumab as scheduled up to 52 weeks. Compared with biologic-experienced group, biologic-naive group had a significantly higher PASI 50/75/90/100 achievement (p = 0.0098/0.0039/0.0016/0.0054) at week 52. PASI 50/75/90/100 curves in biologic-naive group (p = 0.0117/0.0239/0.0143/0.0269) were also significantly higher when analysed generalized estimating equations (GEE) model. Though there was no statistically significant difference in terms of PASI 50/75/90/100 responses at any time points between those with body weight ≦ 65 kg and those >65 kg, a tendency of secondary failure was noted in those >65 kg from week 40 onwards. Patients who were both biologic-naive and weighed ≦ 65 kg achieved sustained PASI 50/75/90 responses from week 16/28/40 onwards, respectively, indicating that they could be considered as potential candidates for 75 mg risankizumab. Though PASI 75 curve in patients without diabetes mellitus (DM) surpassed that in patient without DM, curves of other parameters did not reach significance when analysed by GEE model. There was no HBV, HCV or TB reactivation, nor other new safety signals during the 52-week observational period. Providing risankizumab with flexible dosing options is beneficial in clinical practice considering the high cost of this medication.
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Affiliation(s)
- Chang-Yu Hsieh
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hsian Tseng
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
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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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Hsieh CY, Tsai TF. Effectiveness and safety of reduced-dose secukinumab switching to risankizumab for psoriasis patients in Asian population: A case series. Exp Dermatol 2023. [PMID: 37032610 DOI: 10.1111/exd.14810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Chang-Yu Hsieh
- Department of Dermatology, National Taiwan University Hospital, Taipei City, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital, Taipei City, Taiwan
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Comparative Effectiveness of Biologics Across Subgroups of Patients with Moderate-to-Severe Plaque Psoriasis: Results at Week 12 from the PSoHO Study in a Real-World Setting. Adv Ther 2023; 40:869-886. [PMID: 36515803 PMCID: PMC9988734 DOI: 10.1007/s12325-022-02379-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In routine clinical care, important treatment outcomes among patients with moderate-to-severe plaque psoriasis (PsO) have been shown to vary according to patient demographics and disease characteristics. This study aimed to provide direct comparative effectiveness data at week 12 between anti-interleukin (IL)-17A biologics relative to other approved biologics for the treatment of PsO across seven clinically relevant patient subgroups in the real-world setting. METHODS From the international, non-interventional Psoriasis Study of Health Outcomes (PSoHO), 1981 patients with moderate-to-severe PsO were grouped a priori according to seven clinically relevant demographic and disease variables with binary categories, which were sex (male or female), age (< 65 or ≥ 65 years), body mass index (≤ 30 or > 30 kg/m2), race (White or Asian), PsO disease duration (< 15 or ≥ 15 years), psoriatic arthritis (PsA) comorbidity (present or absent), and prior biologic use (never or ≥ 1). Across these subgroups, effectiveness was compared between the anti-IL-17A cohort (ixekizumab, secukinumab) versus all other approved biologics and ixekizumab versus five individual biologics. The proportion of patients in each subgroup who achieved 90% improvement in Psoriasis Area and Severity Index (PASI90) and/or static Physician Global Assessment (sPGA) 0/1, PASI100, or PASI90 at week 12 were assessed. Comparative analyses were conducted using frequentist model averaging (FMA). Missing data were imputed using non-responder imputation. RESULTS Patients in each of the seven subgroups achieved similar response rates to those of the overall treatment cohort, apart from patients with PsA treated with other biologics who had 7-10% lower response rates. Consequently, patients with comorbid PsA had significantly higher odds of achieving skin clearance at week 12 with anti-IL-17A biologics compared to other biologics. Patients in all subgroups had significantly higher odds of achieving PASI90 and/or sPGA (0,1), PASI100, and PASI90 in the anti-IL-17A cohort relative to the other biologics cohort, except for the Asian subgroup. No sex- or age-specific differences in treatment effectiveness after 12 weeks were identified, neither between the treatment cohorts nor between the individual treatment comparisons. CONCLUSIONS Despite relative consistency of comparative treatment effectiveness across subgroups, the presence of comorbid PsA may affect a patient's clinical response to some treatments.
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Oguz Topal I, Baysak S, Altunay İK, Kara Polat A, Arıkan EE, Özkur E, Aytekin S, Dogan B, Özkök Akbulut T, Topaloğlu Demir F, Karadağ AS. Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: real-world data from a retrospective multicenter study. An Bras Dermatol 2022; 97:566-574. [PMID: 35843765 PMCID: PMC9453482 DOI: 10.1016/j.abd.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/17/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. OBJECTIVE The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. METHOD The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. RESULTS In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. STUDY LIMITATIONS Retrospective design. CONCLUSIONS These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population.
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Affiliation(s)
- Ilteris Oguz Topal
- Department of Dermatology and Venereology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
| | - Sevim Baysak
- Department of Dermatology and Venereology, University of Health Sciences, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - İlknur Kıvanç Altunay
- Department of Dermatology and Venereology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Asude Kara Polat
- Department of Dermatology and Venereology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Eylem Emel Arıkan
- Department of Dermatology and Venereology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Özkur
- Department of Dermatology and Venereology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sema Aytekin
- Department of Dermatology and Venereology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Bilal Dogan
- Department of Dermatology and Venereology, University of Health Sciences, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Tuğba Özkök Akbulut
- Department of Dermatology and Venereology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Filiz Topaloğlu Demir
- Department of Dermatology and Venereology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Atasehir Hospital, Turkey
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Walsh JA, Callis Duffin K, Van Voorhees AS, Chakravarty SD, Fitzgerald T, Teeple A, Rowland K, Uy J, McLean RR, Malley W, Cronin A, Merola JF. Demographics, Disease Characteristics, and Patient-Reported Outcomes Among Patients with Psoriasis Who Initiated Guselkumab in CorEvitas' Psoriasis Registry. Dermatol Ther (Heidelb) 2021; 12:97-119. [PMID: 34822121 PMCID: PMC8776927 DOI: 10.1007/s13555-021-00637-2] [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: 07/14/2021] [Accepted: 10/29/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Guselkumab is approved for the treatment of both moderate-to-severe plaque psoriasis and active psoriatic arthritis (PsA) in the USA. However, little is known about patients initiating guselkumab in a real-world setting. The objective of this study was to describe baseline characteristics among patients with plaque psoriasis who initiated guselkumab at or after enrollment in CorEvitas’ Psoriasis Registry. Methods Adult patients who initiated guselkumab in the Psoriasis Registry between July 18, 2017 and November 6, 2018 were included. Demographics, disease characteristics, and patient-reported outcome measures (PROMs) were assessed at the time of guselkumab initiation (baseline). Patients with psoriasis were stratified according to the number of previously received biologics (0 to 4+) for comparison. A subset of patients with psoriasis and concomitant dermatologist-diagnosed PsA were stratified into biologic-naïve and biologic-experienced groups. Results Among 687 patients with psoriasis who initiated guselkumab, biologic-naïve patients and those with four or more prior biologics had the most severe disease and the worst PROM scores at baseline. Among 251 patients with concomitant dermatologist-diagnosed PsA, biologic-naïve patients had more severe disease and worse PROM scores than biologic-experienced patients. Conclusions These findings highlight important differences in baseline characteristics according to biologic experience among patients with plaque psoriasis with or without concomitant PsA initiating guselkumab in a real-world setting. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00637-2.
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Affiliation(s)
| | | | | | - Soumya D Chakravarty
- Janssen Scientific Affairs LLC, Horsham, PA, 19044, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Amanda Teeple
- Janssen Scientific Affairs LLC, Horsham, PA, 19044, USA
| | | | - Jonathan Uy
- Janssen Global Services LLC, Horsham, PA, USA
| | | | | | | | - Joseph F Merola
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
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Hung YT, Lin YJ, Chiu HY, Huang YH. Impact of previous biologic use and body weight on the effectiveness of guselkumab in moderate-to-severe plaque psoriasis: a real-world practice. Ther Adv Chronic Dis 2021; 12:20406223211046685. [PMID: 34729147 PMCID: PMC8485267 DOI: 10.1177/20406223211046685] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Real-life data on patients with psoriasis treated with guselkumab are few and are needed to compare with trial-based data. We investigated the effect of clinical factors on real-world effectiveness of guselkumab. Methods: This multicentre study retrospectively included 135 patients with psoriasis treated with guselkumab from June 2018 until November 2020. Effectiveness was assessed using the degree of improvement in the Psoriasis Area and Severity Index (PASI) scores at baseline and after 4, 12, 20, 28, and 36 weeks. Predictors of effectiveness were also evaluated. Results: At week 36, 67% of the patients achieved PASI 75. Multivariate logistic regression analysis revealed that heavier patients were less likely to achieve PASI 75 at week 4 than patients with lower body weights. Fewer patients exposed to only one biologic achieved PASI 75 at weeks 4, 20, 28, and 36 [odds ratio (OR) = 0.08 (95% CI, 0.01–0.48), 0.21 (95% CI, 0.05–0.74), 0.04 (95% CI, 0.00–0.35), and 0.07 (95% CI, 0.00–0.68), respectively] than biologic-naïve patients. Patients previously treated with more than one biologic were less likely to achieve PASI 75 at weeks 12, 20, 28, and 36 [OR = 0.05 (95% CI, 0.01–0.22), 0.03 (95% CI, 0.01–0.16), 0.00 (95% CI, 0.00–0.03), and 0.00 (95% CI, 0.00–0.044), respectively] than biologic-naïve patients. Patients with previous anti-interleukin (IL)-17 exposure, rather than tumour necrosis factor-α and IL-12/23 inhibitors, had lower PASI improvements to guselkumab than biologic-naïve patients at weeks 12, 20, and 28 [OR = 0.19 (95% CI, 0.03–0.90), 0.10 (95% CI, 0.02–0.55), and 0.03 (95% CI, 0.00–0.29), respectively]. Conclusions: The effectiveness of guselkumab was compromised in a real-world setting. Delayed onset of therapeutic response was noted in heavier patients. Biologic exposure, the number of previously used biologics, and previous exposure to IL-17 inhibitors were clinical predictors of a reduced response to guselkumab. Physicians may share this information with patients to make treatment decisions.
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Affiliation(s)
- Yi-Teng Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City
| | - Yu-Jr Lin
- Research Services Center for Health Information, Chang Gung University, Taoyuan City
| | - Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hsin-Chu Hospital, No. 25, Lane 442, Section 1, Jingguo Road, Hsinchu City 300
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333. School of Medicine, College of Medicine, Chang Gung University, Taoyuan City
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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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11
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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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12
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Nguyen HT, Pham NTU, Tran TNA, Nguyen NTT, Vu TTP. Secukinumab Demonstrated High Effectiveness in Vietnamese Patients with Moderate-To-Severe Plaque Psoriasis in a Real-World Clinical Setting: 16 Week Results from an Observational Study. Dermatol Ther (Heidelb) 2021; 11:1613-1621. [PMID: 34275123 PMCID: PMC8484422 DOI: 10.1007/s13555-021-00581-1] [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: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction Plaque psoriasis (PsO), characterized by demarcated, erythematous, scaly skin, can have a substantial negative impact on patients’ quality of life. This observational (non-interventional) retrospective study was conducted to characterize treatment patterns and response among patients with plaque PsO treated with secukinumab under routine medical practice in Vietnam. Methods Patient medical records from the specialized clinic of the Ho Chi Minh City Hospital of Dermato-Venereology (N = 236) were collected. Patients (male or female) aged ≥ 18 years with moderate-to-severe chronic plaque PsO, defined as > 10% involvement of the body surface area (BSA > 10) or a Psoriasis Area and Severity Index (PASI) score > 10 and a Dermatology Life Quality Index (DLQI) score > 10, were included. Results In total, 230 patients met the inclusion criteria and were included in the intention-to-treat (ITT) population, the majority of whom were men (66.1%). At baseline, the mean ± standard deviation (SD) age of the ITT population was 41.46 ± 14.29 years, mean disease duration was 7.91 ± 7.91 years, and 27% (n = 62) were obese. More than 90% of the patients were biologic naïve prior to initiation of secukinumab therapy. At week 4, 54.6% patients (n = 124) achieved ≥ 75% reduction in PASI scores from baseline (PASI 75). By week 16, 81.1, 68.9, and 36.5% of the overall population (n = 180, 153, and 81) achieved PASI scores of 75, 90, and 100, respectively; 66.1% of the overall population (n = 154) reported DLQI scores of 0/1 by week 16. The effectiveness of secukinumab was validated in subgroups of patients with or without obesity, concomitant conditions (hepatitis B virus, hepatitis C virus, diabetes, high blood pressure, gout, and/or obesity [body mass index ≥ 30 kg/m2]), and concomitant psoriatic arthritis (PsA). Conclusion The study validated the real-world effectiveness of secukinumab in Vietnamese patients irrespective of obesity, concomitant conditions, and concomitant PsA status.
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Affiliation(s)
- Hao T Nguyen
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, District 3, Ho Chi Minh City, Vietnam.
| | - Nhi T U Pham
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, District 3, Ho Chi Minh City, Vietnam
| | - Tu N A Tran
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, District 3, Ho Chi Minh City, Vietnam
| | | | - Thao T P Vu
- Ho Chi Minh City Hospital of Dermato-Venereology, 2 Nguyen Thong, District 3, Ho Chi Minh City, Vietnam
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13
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Lo Y, Tsai TF. Updates on the Treatment of Erythrodermic Psoriasis. PSORIASIS (AUCKLAND, N.Z.) 2021; 11:59-73. [PMID: 34136373 PMCID: PMC8200157 DOI: 10.2147/ptt.s288345] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/20/2021] [Indexed: 12/30/2022]
Abstract
Erythrodermic psoriasis (EP) is a rare variant of psoriasis, which is potentially life threatening and often resistant to conventional therapy. Biologics have revolutionized the treatment of plaque-type psoriasis, and shown promise in EP. However, due to the lack of head-to-head studies and the rarity of EP, no high level evidence-based treatment guidelines for EP have been established, and the evidence of treatment of EP is limited to case reports or small case series. Here, we present a narrative review focusing on the up-to-date information for the treatment of EP.
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Affiliation(s)
- Yang Lo
- Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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14
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Zhao Y, Cai L, Liu XY, Zhang H, Zhang JZ. Efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis: a real-life cohort study. Chin Med J (Engl) 2021; 134:1324-1328. [PMID: 33950871 PMCID: PMC8183798 DOI: 10.1097/cm9.0000000000001510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There have been few real-life dose-comparing studies on the efficacy and safety of secukinumab in Chinese patients with plaque psoriasis. We conducted a real-life cohort study to investigate the efficacy and safety of secukinumab 150 and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis. METHODS A total of 106 patients with moderate-to-severe plaque psoriasis were included in this study. Patients received either secukinumab 150 mg or secukinumab 300 mg according to patients' weights and severity of psoriasis. The treatment continued for at least 24 weeks. The efficacy was evaluated by improvement in the psoriasis area and severity index (PASI) scores. The safety was also analyzed. RESULTS Fifty-nine patients (55.7%) were treated with secukinumab 300 mg and 47 patients (44.3%) were treated with secukinumab 150 mg. After 12-week treatment, PASI75/90/100 responses were achieved in 100%, 97.8%, and 95.7% of patients, respectively, in secukinumab 150 mg group, and the efficacy was maintained to week 24. In secukinumab 300 mg group, PASI75/90/100 responses were achieved in 93.2%, 81.4%, and 76.3% of patients, respectively, at week 12. In this group, PASI75/90/100 responses reached 91.5%, 86.4%, and 79.9%, respectively, at week 24. Biologic-experienced patients had lower responses than biologic-naïve patients. Secukinumab 150 and 300 mg were well tolerated. Five patients discontinued treatment due to poor response, adverse event, or economic reasons. CONCLUSIONS This real-life study demonstrated that high PASI 90 and PASI 100 responses were achieved in Chinese psoriasis patients receiving secukinumab 150 or 300 mg. Biologic-naïve was associated with better clinical efficacy.
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Affiliation(s)
- Yan Zhao
- Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
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15
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Goon PKC, Lim HY, Summerfield L, Banfield CC, Sudhoff H, Mallett D. Real-world experience and analyses of the performance of ixekizumab as first-line biologic agent versus second-line (or higher) biologic agent in the treatment of chronic plaque psoriasis. Int J Dermatol 2021; 60:e319-e320. [PMID: 33817799 DOI: 10.1111/ijd.15560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/28/2021] [Accepted: 03/17/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Peter Kin Cho Goon
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | - Hai-Yee Lim
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | - Liz Summerfield
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | | | | | - Dick Mallett
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
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16
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Ergun T, Seckin D, Demir G, Direskeneli H. Secukinumab and infectious adverse effects: A real-life experience of 63 psoriasis patients. Australas J Dermatol 2021; 62:e423-e426. [PMID: 33788261 DOI: 10.1111/ajd.13588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/31/2021] [Accepted: 02/15/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Tulin Ergun
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Dilek Seckin
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gizem Demir
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
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17
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Kearney N, McKenna K. Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis - does therapeutic drug monitoring have a place in routine clinical practice? J DERMATOL TREAT 2021; 33:1676-1681. [PMID: 33656955 DOI: 10.1080/09546634.2021.1898526] [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: 10/22/2022]
Abstract
Background: Psoriasis is a chronic disorder with increasing new treatments targeting the T-helper cell (Th)-1/Th17 axis. There remains a subset of patients who experience a primary or secondary failure to biologic treatments.Methods: We present ten patients with psoriasis who failed biologic therapy with measurement of serum drug levels and anti-drug antibody levels (ADAs) with review of the current literature. Our objective was to identify demographic factors, disease status, drug level and ADAs which might correlate with primary and secondary failure.Results: There are a number of factors affecting drug levels in patients with psoriasis on biologics including the presence of ADAs, patient adherence to treatment regimes, pharmacogenetics and the pharmacokinetic properties of the drug following subcutaneous injection. Our results demonstrate that biologic failure is related to low serum drug levels subtherapeutic in 80% of our cohort. Primary failure may correlate with the presence of ADAs but not with serum drug levels. All patients were ANA negative and there remains considerable debate on the utility of routine ANA testing.Conclusions: The role of therapeutic drug monitoring in dermatology remains uncertain and requires further study. We aim to promote debate in the dermatology community as to the utility of therapeutic drug monitoring in routine practice.
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Affiliation(s)
- Niamh Kearney
- Department of Dermatology, Belfast City Hospital, Belfast, Northern Ireland
| | - Kevin McKenna
- Department of Dermatology, Belfast City Hospital, Belfast, Northern Ireland
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18
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Hampton P, Halliday A, Aassi M, Subramanian S, Jain M, Griffiths CEM. Twelve-week secukinumab treatment is consistently efficacious for moderate-to-severe psoriasis regardless of prior biologic and non-biologic systemic treatment: Post hoc analysis of six randomised trials. J Eur Acad Dermatol Venereol 2021; 35:928-937. [PMID: 33030755 PMCID: PMC7986672 DOI: 10.1111/jdv.16982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/22/2020] [Indexed: 01/12/2023]
Abstract
Background The efficacy of biologic therapies is greater among biologic‐naïve vs. biologic‐experienced psoriasis patients. However, little is known as to whether prior use of other systemic therapies impacts secukinumab efficacy in patients with moderate‐to‐severe psoriasis. Objective To investigate the impact of prior exposure to systemic therapies upon the efficacy and safety of secukinumab 300 mg for moderate‐to‐severe psoriasis. Methods Post hoc analysis of six randomised controlled trials (RCTs) comparing secukinumab with placebo, ustekinumab or etanercept at 12 weeks of treatment. Data comparing secukinumab with placebo and ustekinumab were meta‐analysed, while comparisons between secukinumab and etanercept were from a single RCT. Four subgroups of patients were assessed: (i) naïve to non‐biologic systemics (NBS) and biologics; (ii) exposed to NBS but naïve to biologics; (iii) naïve to NBS but exposed to biologics; and (iv) exposed to NBS and biologics. Outcomes of interest included the following: investigator’s global assessment (IGA) score, absolute psoriasis area and severity index (PASI) response, PASI 75, PASI 90 and PASI 100 responses, and dermatology life quality index (DLQI). Safety was also assessed. Results One thousand three hundred and eighty‐three patients were included in the secukinumab vs. placebo meta‐analysis: 1776 in the secukinumab vs. ustekinumab meta‐analysis and 653 in the within‐trial analyses of secukinumab vs. etanercept. For all subgroups, secukinumab was significantly more efficacious than placebo for all outcomes measured. Secukinumab generated greater responses in biologic‐naïve patients, while prior NBS had a negligible impact on treatment response. Furthermore, secukinumab was more efficacious than both ustekinumab and etanercept on many outcomes, with an even greater difference for biologic‐naïve than biologic‐exposed patients. Safety results were consistent with individual clinical trial results. Conclusions Twelve‐week treatment with secukinumab 300 mg is consistently more efficacious than placebo, etanercept and ustekinumab in patients with moderate‐to‐severe psoriasis, regardless of prior exposure to biologics or NBS. Secukinumab had a comparable safety profile to both etanercept and ustekinumab.
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Affiliation(s)
- P Hampton
- Newcastle Dermatology, Newcastle Hospitals NHS Trust, Newcastle Upon Tyne, UK
| | - A Halliday
- Novartis Pharmaceuticals UK Limited, Surrey, UK
| | - M Aassi
- Novartis Pharma AG, Basel, Switzerland
| | | | - M Jain
- Novartis Healthcare Pvt. Ltd, Hyderabad, India
| | - C E M Griffiths
- Centre for Dermatology, The University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester, UK
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19
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Treatment Response of Patients with Erythrodermic Psoriasis after Switching to Guselkumab. Dermatol Ther (Heidelb) 2021; 11:301-306. [PMID: 33400156 PMCID: PMC7858723 DOI: 10.1007/s13555-020-00480-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Erythrodermic psoriasis (EP) is a rare variant of psoriasis. Due to its rarity, evidence supporting its treatment is limited. Patients with erythrodermic psoriasis often respond less favorably to conventional treatment and have lower biologic drug survival compared with patients with plaque-type psoriasis. Guselkumab is an anti-interleukin-23 (IL-23) monoclonal antibody and has shown excellent and sustained treatment effect in moderate-to-severe plaque-type psoriasis. Until now, there is only one phase III open-label study reporting the effectiveness of guselkumab in this patient group. METHODS Patients with chronic erythrodermic psoriasis who had been commenced on guselkumab were included in this retrospective study. All except one of our patients had plaque-type psoriasis prior to EP, and they met the criteria for EP before use of guselkumab. Due to inadequate response to previous treatment, including biologics, they were switched to guselkumab treatment. There was no washout period. They received guselkumab 100 mg at weeks 0 and 4, then every 8 weeks until at least week 28. Data were collected for patient demographics, Patient Area and Severity Index (PASI), and previous treatments. RESULTS A total of 13 patients (12 male, 1 female) were included. The mean PASI improvement at weeks 4, 12, 20, and 28 was 37.5%, 60.9%, 67.5%, and 64.7%, respectively. The percentage of PASI 75 responders at weeks 4, 12, 20, and 28 was 15.4%, 38.5%, 53.9%, and 46.2%, respectively. At week 12, eight patients (61.5%) could achieve PASI 50 response. These PASI 50 responders at week 12 showed sustained and improved effectiveness during follow-up. CONCLUSION Guselkumab is an effective biologic for treatment of moderate-to-severe plaque-type psoriasis, but the efficacy and drug survival are still compromised in EP patients. Our data describe the real-world experience of guselkumab treatment in this rare group of patients. Despite previous failure of other biologics, PASI response at week 12 is a good predictor of patient response and drug survival of guselkumab.
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20
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Caldarola G, Mariani M, Pirro F, Nicolotti N, Burlando M, Calabrese L, Parodi A, Peris K, De Simone C. Comparison of short- and long-term effectiveness of ixekizumab and secukinumab in real-world practice. Expert Opin Biol Ther 2021; 21:279-286. [PMID: 33170052 DOI: 10.1080/14712598.2021.1849133] [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] [Indexed: 12/14/2022]
Abstract
Background: Although secukinumab and ixekizumab both act by inhibiting IL-17A, some scientific evidence suggests that there are differences in efficacy between the two agents. Objective: The aim of this study was to compare the short- and long-term effectiveness of ixekizumab and secukinumab in clinical practice. Methods: A retrospective study was conducted on a cohort of 245 psoriatic patients receiving secukinumab or ixekizumab during the period from September 2016 to December 2019. The proportion of patients achieving PASI75, PASI90, and PASI100 at weeks 12 and 24 was calculated. We recorded the 12- and 24-month drug survival as a measure to assess long-term effectiveness. Results: A higher proportion of patients in the secukinumab group achieved PASI75, 90, and 100 at 12 weeks. The Kaplan-Meier survival curve for any reason of discontinuation showed no differences between the two groups. Instead, the multivariate analysis for ineffectiveness, adjusted for potential confounders, showed a lower drug survival rate in the secukinumab group, with an adjusted HR of 2.57 (95% CI 1.05-6.28, p 0.038). Conclusion: This real-life study demonstrated that ixekizumab and secukinumab are both highly effective in short- and long-term treatment of psoriasis, even though few differences exist concerning speed of action and long-term effectiveness.
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Affiliation(s)
- Giacomo Caldarola
- Institute of Dermatology, Università Cattolica Del Sacro Cuore , Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Marco Mariani
- Dipartimento Di Scienze Della Vita E Sanità Pubblica, Università Cattolica Del Sacro Cuore , Rome, Italy.,Public Health and Preventive Medicine Specialist, Medical Management Università Cattolica , Rome
| | - Federico Pirro
- Institute of Dermatology, Università Cattolica Del Sacro Cuore , Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Nicola Nicolotti
- Dipartimento Di Scienze Della Vita E Sanità Pubblica, Università Cattolica Del Sacro Cuore , Rome, Italy.,Public Health and Preventive Medicine Specialist, Medical Management Università Cattolica , Rome
| | - Martina Burlando
- Institute of Dermatology, DissaL, Policlinico San Martino-IRCCS , Genova, Italy
| | - Laura Calabrese
- Institute of Dermatology, Università Cattolica Del Sacro Cuore , Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Aurora Parodi
- Institute of Dermatology, DissaL, Policlinico San Martino-IRCCS , Genova, Italy
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica Del Sacro Cuore , Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
| | - Clara De Simone
- Institute of Dermatology, Università Cattolica Del Sacro Cuore , Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy
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21
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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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22
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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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Abstract
INTRODUCTION A number of highly selective biologic therapies that target specific immunological pathways of psoriasis have emerged, including molecules that target interleukin (IL)-17. IL-17 has been identified as a key effector pathogenic cytokine in psoriasis, and validated as a highly effective therapeutic target for the treatment of plaque psoriasis. AREA COVERED This review examines the therapeutic efficacy and safety of IL-17 inhibitors in plaque psoriasis and provides an overview of the efficacy and safety data of brodalumab compared with other IL-17 inhibitors. EXPERT OPINION In the real world, the treatment of psoriasis has been revolutionized by the new class of drugs belonging to IL-17 inhibitors, with secukinumab, ixekizumab, and brodalumab currently licensed and approved for the treatment of moderate-to-severe plaque psoriasis. With its distinct mechanism of action, brodalumab may offer a unique advantage over other IL-17 inhibitors due to its rapid onset of action, achievement of complete skin clearance in a high proportion of patients, and its overall favorable safety profile. Importantly, treatment with systemic biologic drugs should be established early on in the course of the disease in order to prevent comorbidities and to allow patients to achieve a stable and persistent remission.
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Affiliation(s)
- Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona , Verona, Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona , Verona, Italy
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24
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Reduced Efficacy of Biological Drugs in Psoriatic Patients with HLA-A Bw4-80I KIR Ligands. Mol Diagn Ther 2020; 24:311-314. [PMID: 32189206 DOI: 10.1007/s40291-020-00457-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Biological drugs (biologics) are a highly effective therapy for the moderate to severe form of psoriasis, an immune-mediated dermatosis with a strong immunogenetic component. The interaction between human leukocyte antigen (HLA) class I ligands and killer immunoglobulin-like receptors (KIR) has a functional significance in the education of natural killer (NK) cells, and can thus influence the response to biologics. OBJECTIVE In this study, we investigated the impact of HLA-A and -B KIR ligands in the response to biologics in a cohort of psoriatic patients. METHODS Eighty-five patients with moderate to severe psoriasis treated with biologics (adalimumab, etanercept, infliximab, ustekinumab and secukinumab) were enrolled in the study. Clinical response was evaluated as patients attaining 50%, 75% or 90% reduction in the Psoriasis Area and Severity Index (PASI) (PASI 50, 75 or 90, respectively) over 6 months' follow-up. Poor response was defined as PASI 50, and in this case patients shifted to treatment with a different biologic. Fifty-two patients (61.2%) showed excellent response (PASI 90) to the first biologic, while 33 patients (38.8%), needed two or more biologics before reaching an excellent response (PASI 90) and were considered difficult to treat. RESULTS Only HLA-A Bw4-80I ligands were associated with the response to biologics; in particular, they were linked with reduced response both at univariable analysis (odds ratio [OR] 3.11, 95% confidence interval [CI] 1.19-8.07; p = 0.019) and multivariable analysis (OR 5.02, 95% CI 1.40-17.97; p = 0.013). CONCLUSION We suggest that the HLA-A Bw4-80I epitope could be a marker of reduced responsiveness to biologics. The possible reason for this is an increase of tumour necrosis factor (TNF)-α and the silencing of NK cells through the predominant interaction with the KIR3DL/S pair. HLA-KIR affinities might lead to a more efficient way to prescribe biologics.
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25
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Herrera-Acosta E, Garriga-Martina GG, Suárez-Pérez JA, Martínez-García EA, Herrera-Ceballos E. Comparative study of the efficacy and safety of secukinumab vs ixekizumab in moderate-to-severe psoriasis after 1 year of treatment: Real-world practice. Dermatol Ther 2020; 33:e13313. [PMID: 32181962 DOI: 10.1111/dth.13313] [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: 02/03/2020] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 12/20/2022]
Abstract
There are no studies which directly compare efficacy in Psoriasis Area and Severity Index (PASI) response of secukinumab and ixekizumab. The main aim of this study was to compare the efficacy and safety of both drugs used to treat moderate-to-severe psoriasis patients over 52 weeks. Secondary objectives were to identify which factors related to prior biologic treatment influenced their efficacy and analyze data obtained at 12 weeks. A retrospective observational study was carried out, in which a group of the first 59 patients treated with secukinumab after its commercialization, was compared with another group of the first 29 patients treated with ixekizumab. The PASI 75, 90, and 100 response obtained at 52 weeks was 64.4%, 49.2%, and 41.4% for secukinumab and 75.9%, 62.1%, and 41.4% for ixekizumab, respectively, with no statistically significant differences. Regarding previous biological treatment, both treatments showed a decrease in efficacy as the number of prior biologics increases. No differences were found between secukinumab and ixekizumab in bio-naïve or bio-experienced patients, with the exception of a higher PASI 75 response at week 52 for ixekizumab in those patients with two or more previous biologics (P = .039) Secukinumab and ixekizumab have demonstrated high efficacy and safety, with no statistically significant differences.
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Affiliation(s)
- Enrique Herrera-Acosta
- Department of Dermatology, Hospital Clínico Virgen de la Victoria, University of Malaga, Malaga, Spain
| | - Gustavo G Garriga-Martina
- Department of Dermatology, Hospital Clínico Virgen de la Victoria, University of Malaga, Malaga, Spain
| | - Jorge A Suárez-Pérez
- Department of Dermatology, Hospital Clínico Virgen de la Victoria, University of Malaga, Malaga, Spain
| | - Eliseo A Martínez-García
- Department of Dermatology, Hospital Clínico Virgen de la Victoria, University of Malaga, Malaga, Spain
| | - Enrique Herrera-Ceballos
- Department of Dermatology, Hospital Clínico Virgen de la Victoria, University of Malaga, Malaga, Spain
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26
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Ruiz‐Villaverde R, Rodriguez‐Fernandez‐Freire L, Galán‐Gutierrez M, Armario‐HIta JC, Martinez‐Pilar L. Drug survival, discontinuation rates, and safety profile of secukinumab in real‐world patients: a 152‐week, multicenter, retrospective study. Int J Dermatol 2020; 59:633-639. [DOI: 10.1111/ijd.14819] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/29/2019] [Accepted: 01/24/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Ricardo Ruiz‐Villaverde
- UGC Dermatología Hospital Universitario San Cecilio Granada Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA Granada Spain
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27
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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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28
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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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29
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Tsai T. Secukinumab in patients with psoriasis who have responded inadequately to tumour necrosis factor inhibitor treatment. Br J Dermatol 2020; 183:7-8. [DOI: 10.1111/bjd.18869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- T.‐F. Tsai
- Department of Dermatology National Taiwan University Hospital and National Taiwan University College of Medicine 7 Zhong‐Shan South Road Zhongzheng District, Taipei 10002 Taiwan
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30
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Galluzzo M, D'Adamio S, Silvaggio D, Lombardo P, Bianchi L, Talamonti M. In which patients the best efficacy of secukinumab? Update of a real-life analysis after 136 weeks of treatment with secukinumab in moderate-to-severe plaque psoriasis. Expert Opin Biol Ther 2019; 20:173-182. [PMID: 31880166 DOI: 10.1080/14712598.2020.1708897] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: There is limited long-term, real-world evidence on the efficacy and safety in patients with plaque psoriasis treated with secukinumab. We present results at 136 weeks in a real-world setting with focus on special populations.Research design and methods: Retrospective analysis of 151 patients with chronic plaque psoriasis who initiated treatment with secukinumab between September 2015 and May 2019. Secukinumab 300 mg was administered once weekly for 5 weeks followed by once monthly.Main outcome measures: Clinical and laboratory assessments were performed up to 136 weeks.Results: At 16 weeks, 90%, 79%, and 63% of patients achieved Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100, respectively, compared with 79%, 72%, and 55% of patients after 136 weeks of therapy with secukinumab. Fifteen of the 151 patients experienced an adverse event, the most common of which was candida infection (4%). Biological treatment naïve was significantly associated with response to therapy at 1 and 2 years (P < 0.0001). There were no safety issues in patients with infection with HBV, HCV or mycobacterium tuberculosis.Conclusions: Our results confirm the rapidity of action of secukinumab as well as its long-lasting efficacy and good safety in real-world clinical practice.
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Affiliation(s)
- Marco Galluzzo
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of "Experimental Medicine", University of Rome "Tor Vergata", Rome, Italy
| | - Simone D'Adamio
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Paolo Lombardo
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy
| | - Marina Talamonti
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy
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31
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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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32
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Rompoti N, Katsimbri P, Kokkalis G, Boumpas D, Ikonomidis I, Theodoropoulos K, Rigopoulos D, Papadavid E. Real world data from the use of secukinumab in the treatment of moderate-to-severe psoriasis, including scalp and palmoplantar psoriasis: A 104-week clinical study. Dermatol Ther 2019; 32:e13006. [PMID: 31228319 DOI: 10.1111/dth.13006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/31/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022]
Abstract
Several clinical studies demonstrated the safety and efficacy of the interleukin-17 inhibitor secukinumab in the systemic treatment of moderate-to-severe psoriasis, as well as psoriatic arthritis (PsA) in adults, whereas real-world data is limited. A single-center clinical study was performed to evaluate in real-world practice the efficacy of secukinumab up to Week 104 of treatment in moderate-to-severe chronic plaque psoriasis, including scalp and palmoplantar involvement, according to Physician Global Assessment (PGA), PASI75/90/100 and scalp, and palmoplantar PGA. Drug survival, the safety profile of secukinumab, and patient's quality of life were also assessed during a 2-year observation period. Out of 83 patients included, 56.3% were biologic-naïve, and 94% had scalp, 25.3% palmoplantar, and 43.9% joint involvement. At Week 16, PASI75/PASI90/PASI100 were observed in 83.8/70.0/46.3%, respectively. Scalp and palmoplantar PGA were rapidly improved, with 98.7 and 95.5%, respectively, reaching clear/almost clear skin at Week 16. After 104 weeks, drug survival was 74.5%. A significant improvement of the quality of life was observed. Biologic-naïve patients without coexisting PsA benefited the most. Real-world data demonstrated secukinumab efficacious in chronic plaque psoriasis, including specific locations such as scalp and palmoplantar psoriasis with a safety profile similar to that in clinical trials.
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Affiliation(s)
- Natalia Rompoti
- Second Department of Dermatology and Venereology, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,First Department of Dermatology and Venereology, "Syggros", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Pelagia Katsimbri
- Fourth Department of Internal Medicine, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgios Kokkalis
- Second Department of Dermatology and Venereology, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitrios Boumpas
- Fourth Department of Internal Medicine, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ignatios Ikonomidis
- Second Department of Cardiology, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Theodoropoulos
- Second Department of Dermatology and Venereology, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Rigopoulos
- First Department of Dermatology and Venereology, "Syggros", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelia Papadavid
- Second Department of Dermatology and Venereology, "Attikon", University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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