Safety of secukinumab in the treatment of psoriasis

Abstract

Introduction: Secukinumab is a human monoclonal antibody that selectively targets and neutralizes interleukin (IL)-17A, a cytokine that is normally involved in mucocutaneous defense against extracellular organisms and is abnormally expressed in psoriasis. In 2015, secukinumab was the first IL-17A inhibitor approved for the treatment of moderate-to-severe psoriasis. Areas covered: This review evaluates the safety profile of secukinumab for the treatment of moderateto-severe psoriasis and its role in the clinical landscape. A literature search was performed for articles published through February 2016; additional data from a pooled safety analysis of 10 Phase II and III secukinumab studies were reviewed. Expert opinion: Collectively, these studies show that secukinumab demonstrates a highly favorable safety profile, especially compared with commonly used psoriasis treatments such as methotrexate and TNF-α blockers. More specifically, secukinumab carries no increased risks for end-organ toxicities, serious infection, multiple sclerosis, reactivation of latent tuberculosis or hepatitis B, leukemia/lymphoma, and nonmelanoma skin cancer. Mucocutaneous candidiasis is a common side effect and occurs at a rate of 3.55/100 subject-years with secukinumab 300 mg, yet these infections usually do not interfere with maintenance of secukinumab therapy. The combination of proven efficacy and safety make secukinumab an excellent new treatment choice for individuals with moderate-to-severe psoriasis.ARTICLE HISTORY

Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics

“…No cases of TB reactivation were recorded, and the same resulted from a pooled safety analysis of 10 studies of SCK in psoriasis [186]. …”

Safety of biologics in psoriasis

“…However, secukinumab was approved the earliest out of the three in the USA, Europe and Japan, providing a relatively larger amount of available safety data. Thus far, clinical data on secukinumab indicate a highly favorable safety profile, especially compared with methotrexate and TNF‐α inhibitors . One of the common adverse effects of interest in IL‐17 inhibitors is mucocutaneous candidiasis, yet these infections usually do not lead to interruption of IL‐17 inhibitors.…”

Challenges in the treatment of psoriasis with biologics: vaccination, history of malignancy, human immunodeficiency virus (HIV) infection, and pediatric psoriasis

“…Data on secukinumab safety indicate that so far the incidence of malignant or unspecified tumors reported in patients under this agent is comparable with the expected rates for patients with psoriasis in general . As mentioned above, the recommendation stated in the German Guidelines for Psoriasis 2017 is to favor ustekinumab or secukinumab over TNF inhibitors in patients with a history of malignancy .…”