Efficacy and Safety of Secukinumab in Elderly Subjects with Moderate to Severe Plaque Psoriasis: A Pooled Analysis of Phase III Studies

Abstract

BackgroundPsoriasis is a chronic inflammatory skin disease, affecting patients of a wide age range, including elderly patients. Elderly patients can respond differently to drug treatments and can be more vulnerable to adverse reactions. There are limited data on biologic therapies for psoriasis in elderly subjects. Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has proven significant efficacy in the treatment of moderate to severe psoriasis.AimsA post-hoc analysis of three phase III trials (ERASURE, FIXTURE and CLEAR) was performed to evaluate the efficacy and safety of secukinumab in elderly subjects.MethodsStudies were multicentre, randomized, parallel-group, double-blind, 52-week phase III trials in subjects with moderate to severe plaque psoriasis. For efficacy analyses, 67 elderly subjects (≥ 65 years) treated with secukinumab 300 mg were compared with 841 younger subjects (18–64 years). Psoriasis Area and Severity Index (PASI), Dermatological Life Quality Index (DLQI) and safety were analysed.ResultsElderly subjects had higher baseline frequencies of cardiovascular and metabolic disorders. Secukinumab efficacy in elderly subjects was comparable to that in younger subjects throughout 52 weeks of treatment. PASI 75 response was reached by 81.8% of elderly subjects and 79.4% of younger subjects at Week 52. Similar rates of DLQI 0/1 response were observed. The total rate of adverse events was similar between elderly and younger subjects.ConclusionsSecukinumab at the recommended dose (300 mg) is effective and acceptably safe in subjects aged ≥ 65 years with moderate to severe psoriasis, with quality-of-life benefits, despite an increased prevalence of cardiovascular and metabolic comorbidities in this population.Electronic supplementary materialThe online version of this article (10.1007/s40266-018-0520-z) contains supplementary material, which is available to authorized users.

Treatment of Psoriasis with Secukinumab in Challenging Patient Scenarios: A Review of the Available Evidence

“…Elderly patients (aged 65 years or more) with PsO are challenging to treat as this population has a higher prevalence of comorbidities, which may lead to inadequate treatment responses and higher risk of adverse events [27]. Although elderly patients with moderate to severe PsO in clinical trials had a higher baseline frequency of cardiovascular and metabolic disorders, the efficacy of secukinumab was comparable to that in a younger population at 52 weeks (percentage of patients experiencing PASI75, 81.8% vs 79.4%, respectively), with a safety profile consistent with that described in other studies of biologics in elderly populations [28].…”

Real‐life efficacy and safety of secukinumab in elderly patients with psoriasis over a 2‐year period

“…11 Additionally, a post hoc analysis of three phase III secukinumab trials displayed a comparable PASI75 response between elderly and younger patients up to week 52. 12 Given the scarcity of data about anti-IL17 drugs in elderly patients with psoriasis, we performed the present retrospective observational study on geriatric psoriasis treated with secukinumab over a 2-year period. Our results support the high efficacy profile of secukinumab in elderly patients with psoriasis up to 96 weeks of treatment, with a final mean PASI and BSA reduction of 85.1% and 88.0%, respectively.…”

Secukinumab in moderate-to-severe plaque psoriasis: a multi-center, retrospective, real-life study up to 52 weeks observation

“…A recent post hoc analysis of three phase III trials was performed to evaluate efficacy and safety of the label dose of secukinumab 300 mg in subjects with moderate-to-severe PsO stratified by age into an elderly and a younger group [22]. The two groups of patients included in this analysis showed several distinct differences at baseline.…”