Secukinumab in multi-failure psoriatic patients: the last hope?

Abstract

Psoriasis is a multi-systemic chronic inflammatory disease that affects about 1.5-3% of the general population, of which almost 20% suffer from a moderate-severe form. Those patients can be treated with a systemic agent and in case of scarce response or contraindications, they may require a biologic therapy, such as tumor necrosis factor or interleukin-12/23 inhibitors. When also these agents fail, clinicians face a true therapeutic challenge. We report a case series of multi-failure 16 patients, successfully treated with secukinumab, a human monoclonal antibody that selectively neutralizes interleukin-17 A and is recently approved for the treatment of plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis.

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

“…Our finding that in most patients with PsA an improvement of both cutaneous and joint involvement was observed, and was maintained until week 52 independently of the type of joint involvement, supports the efficacy described in previous studies focusing on PsA [14,20].…”

“…Our study describes real-life data on secukinumab treatment in a higher number of patients and with a longer follow-up compared with the three previous real-life reports [19][20][21]. The demographic data in our cohort are similar to those reported in previous RCTs [11][12][13][14][15][16][17][18], except for the average age of patients, which was 47.5 years in our study versus 44.9 and 44.5 years in the phase III RCTs.…”

“…The 300-mg schedule dosing was found to be more effective than 150 mg: at week 12, PASI75 response was observed in 66.7% of patients on secukinumab 300 mg versus 52.9% on 150 mg. Finally, an Italian case series by Magnano and colleagues [20] has reported the efficacy of secukinumab in 16 psoriatic patients who had been previously treated with at least three biologic agents. At week 12, PASI90 responses were observed in 87.5% of patients without any serious AEs.…”

“…For this reason, it is crucial to integrate data obtained from clinical trials with those of real life, which include different patients' populations, patients with different disease severity and multiple concomitant diseases. To date, only three real-life studies have investigated the efficacy and safety of secukinumab, over a maximum follow-up period of 12 weeks [19][20][21]. The aim of this multicenter, retrospective study was to analyze the efficacy and safety of secukinumab in a patient population from Central Italy with moderate-to-severe psoriasis, over a 52-week treatment period.…”

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

“…A significant amount of efficacy and safety data is extracted from RCTs, whereas limited data is available in a real-world setting (Ferrières et al, 2019;Galluzzo et al, 2018;Georgakopoulos, Ighani, Zhou, & Yeung, 2018;Magnano et al, 2018;Schwensen et al, 2017;Sotiriou, Tsentemeidou, Vakirlis, Sideris, & Ioannides, 2019) where patients' clinical characteristics may differ from those enrolled in clinical programs. The aim of this study was to analyze the efficacy of secukinumab at Weeks 4,16, 52, and 104 of treatment in patients with moderate-to-severe chronic plaque psoriasis, including difficult-to-treat sites (scalp and palmoplantar), at the psoriasis clinic of the Second Dermatology Department of the National and Kapodistrian University of Athens, "Attikon" University Hospital.…”