Secukinumab for patients failing previous tumour necrosis factor‐α inhibitor therapy: results of a randomized open‐label study (SIGNATURE)

Abstract

This study was funded by Novartis Pharmaceuticals U.K. Ltd., and the funders were involved with the study design, data collection, data analysis and manuscript preparation. R.B.W. and C.E.M.G. are supported by the Manchester NIHR Biomedical Research Centre.

Secukinumab in patients with psoriasis who have responded inadequately to tumour necrosis factor inhibitor treatment

“…In patients failing more than one TNF inhibitor, the efficacy of secukinumab was always compromised for both dosages. Adverse events are comparable with the phase III programme for secukinumab, although Candida infection was increased . Efficacy in this report is in line with the results of secukinumab in psoriatic arthritis, which show the need to use 300 mg instead of 150 mg secukinumab in patients who failed to respond to prior TNFi …”

“…In this issue of the BJD , Warren et al . reported the results of a randomized open‐label study of two different dosages of secukinumab, an IL‐17 blocker, in such patients …”

Interleukin-17A and Keratinocytes in Psoriasis

“…As the clinical response to anti-IL-23/IL-17A biologics seems better than that to anti-TNF-α biologics in psoriasis, the IL-23/IL-17A axis likely plays a more crucial role than the TNF-α axis in the development of psoriasis [67][68][69][70][71]. Under the regulation of IL-23p19, IL-17A-producing CD4 + helper T (Th17) cells create a self-amplifying, feed-forward inflammatory response that is markedly augmented in the presence of TNF-α [68,72,73].…”

Risankizumab vs. adalimumab for moderate‐to‐severe plaque psoriasis: a critical appraisal

“…The SIGNATURE trial studied the efficacy of secukinumab in real-world patients who had failed adalimumab therapy, and the results from this type of study design may have greater external validity. 8 The study concludes that risankizumab is more effective than adalimumab and there are no additional safety concerns when switching from adalimumab to risankizumab without a washout period. Although the study was not specifically powered to assess safety, these conclusions are justified as the study was well conducted with high internal validity.…”