Secukinumab shows high efficacy irrespective of<i>HLA-Cw6</i>status in patients with moderate-to-severe plaque-type psoriasis: SUPREME study

Costanzo, Antonio; Bianchi, Luca; Flori, Maria Laura; Malara, Giovanna; Stingeni, Luca; Bartezaghi, Marta; Carraro, L.; Castellino, Gabriella

doi:10.1111/bjd.16705

Cited by 48 publications

(53 citation statements)

References 37 publications

(44 reference statements)

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“…18,19,27 Interestingly, a link between the use of biological drugs such as secukinumab and higher educational attainment was found in our analysis, as also described by Naldi et al 19 In addition, secukinumab has also been suggested in patients with moderate-to-severe psoriasis when a fast response is needed. 28 Overall, the association among patient characteristics, comorbidities and treatment options emerging from our analysis was mostly in-line with published expert opinion on the choice of therapies. For example, a recent publication has recommended ustekinumab and secukinumab as preferred agents for psoriasis patients with obesity, 29 which is also represented by our study.…”

Section: Discussionsupporting

confidence: 78%

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Linkage between patients’ characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry

Cazzaniga

Anzengruber

Augustin

et al. 2019

Acad Dermatol Venereol

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Background Several treatment options are currently available for the treatment of psoriasis. Objective To explore the main associations between patients’ characteristics and systemic treatments prescribed for psoriasis in a large group of patients observed in real‐life clinical practice. Methods This was a retrospective analysis of baseline data collected within the Swiss Dermatology Network for Targeted Therapies registry in Switzerland between March 2011 and December 2017. Semantic map analysis was used in order to capture the best associations between variables taking into account other covariates in the system. Results A total of 549 patients (mean age 46.7 ± 14.7 years) were included in the analysis. Conventional therapies such as retinoids and methotrexate were associated with no previous systemic therapies for psoriasis, a moderate quality of life (QoL) at therapy onset and older age (≥60 years). Fumaric acid derivatives were associated with mild psoriasis (psoriasis area severity index < 10) and long disease duration (≥20 years). On the other side, cyclosporine and psoralen and ultraviolet A/ultraviolet B treatments were linked to a more severe condition, including impaired QoL, hospitalization and inability to work. Regarding biological therapies, both infliximab and adalimumab were connected to the presence of psoriatic arthritis, severe disease condition and other comorbidities, including chronic liver or kidney diseases and tuberculosis. Etanercept, ustekinumab and secukinumab were all connected to a complex history of previous systemic treatments for psoriasis, moderate disease condition, overweight and university education. Conclusions The analysis shows multifaceted associations between patients’ characteristics, comorbidities, disease severity and systemic treatments prescribed for psoriasis. In particular, our semantic map indicates that comorbidities play a central role in decision‐making of systemic treatments usage for psoriasis. Future studies should further investigate specific connections emerging from our data.

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Section: Discussionsupporting

confidence: 78%

“…In addition, secukinumab has also been suggested in patients with moderate‐to‐severe psoriasis when a fast response is needed …”

Section: Discussionmentioning

confidence: 99%

Linkage between patients’ characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry

Cazzaniga

Anzengruber

Augustin

et al. 2019

Acad Dermatol Venereol

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“…Costanzo et al . reported that a similar PASI 90 response was achieved irrespective of HLA‐Cw6 status at week 16, and mean PASI was also comparable at weeks 16 and 24 …”

Section: Systemic Treatmentmentioning

confidence: 76%

HLA-Cw6 and psoriasis

Chen

Tsai

2018

British Journal of Dermatology

127

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Psoriasis is a multifactorial disease with a strong genetic background. HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. It is repeatedly observed to affect disease course, phenotypic features, severity, comorbidities and treatment outcomes. To the best of our knowledge, the roles of HLA-Cw6 in psoriasis have not yet been thoroughly reviewed. The worldwide frequency of the HLA-Cw6 allele varies greatly, with it being generally higher in white people than in Asians. The allele is associated with type I early-onset psoriasis. Stress, obesity and streptococcal pharyngitis are commonly observed in HLA-Cw6-positive patients. Phenotypically, HLA-Cw6 has been found to be associated with guttate psoriasis. In addition, patients carrying the allele are more likely to have arm, leg and trunk involvement, and the Koebner phenomenon. Patients with psoriatic arthritis with HLA-Cw6 more often have early onset and tend to show cutaneous symptoms before musculoskeletal symptoms. HLA-Cw6-positive patients have been shown in several studies to be more responsive to methotrexate and ustekinumab. However, this difference in ustekinumab efficacy was only moderate in a post-hoc analysis of a pivotal phase III study. HLA-Cw6 positivity also tends to be less frequent in high-need patients who fail conventional therapy. Small studies have also investigated the role of HLA-Cw6 in remission of psoriasis during pregnancy, and with the comorbidities of photosensitivity and atherosclerosis. Given the diverse nature of psoriasis pathogenesis, as well as the difference of HLA-Cw6 positivity in different ethnic groups, more studies are needed to confirm the role of HLA-Cw6 in psoriasis.

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“…With the advent of new therapeutic modalities for psoriasis and the introduction of biological therapy for the treatment of psoriasis, several newly published studies showed that there is no association between HLA-Cw06 genetic status and response to treatment especially ustekinumab and Secukinumab. 22 , 23 Other study showed that the presence of HLA-A Bw4-80I could result in reduction in the response to treatment with Etanercept. 24 So HLA alleles play an important role in psoriasis pathogenesis with controversial role in response to biological therapy.…”

Section: Discussionmentioning

confidence: 99%

Relationship between human leukocyte antigen DRB1 and psoriasis in Iraqi patients

Zalzala

Abdullah

Abbas

et al. 2018

SMJ

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Objectives:To investigate the role of Human leukocyte antigen (HLA) Class II DRB1 in susceptibility to psoriasis in Iraqi patients.Methods:A cross-sectional comparative study including 40 patients with psoriasis attending the Department of Dermatology, Al-Kindy teaching hospital in Baghdad, Iraq, between September 2013-2015. Patient selection was carried out by the dermatologists. Ninety healthy individuals were included in the study. Human leukocyte antigen genotyping was carried out by the sequence specific oligonucleotide (SSO) method using Auto LiPA 48 (Innogenetics, Belgium) in the HLA typing research unit of the Al-Kindy College of Medicine, Baghdad, Iraq.Results:There is an increased frequency of HLA-DRB1*0102, *0306 in psoriatic patients with psoriasis p-values=0.001, confidence interval(CI)=2.492-37.487 and odds ratio(OR)=9.666. Human leukocyte antigen-DRB1*1101 is significantly associated with plaque-type psoriasis with p=0.0434, CI=1.04-1.69, and OR=4.2. Human leukocyte antigen-DRB1*0102 is significantly associated with other types of psoriasis with p=0.018, CI=0.0223-0.701, and OR=0.125.Conclusion:Human leukocyte antigen-DRB1*0102 and *0306 are significantly associated with psoriasis. Human leukocyte antigen-DRB1*1101 is significantly associated with plaque-type psoriasis. Human leukocyte antigen-DRB1*0102 is significantly associated with other types of psoriasis rather than plaque-type psoriasis.

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Secukinumab shows high efficacy irrespective ofHLA-Cw6status in patients with moderate-to-severe plaque-type psoriasis: SUPREME study

Abstract: Determination of HLA-Cw6 status for secukinumab therapy is unnecessary, as it is highly effective regardless of HLA-Cw6 status.

Cited by 48 publications

References 37 publications

Linkage between patients’ characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry

Linkage between patients’ characteristics and prescribed systemic treatments for psoriasis: a semantic connectivity map analysis of the Swiss Dermatology Network for Targeted Therapies registry

HLA-Cw6 and psoriasis

Relationship between human leukocyte antigen DRB1 and psoriasis in Iraqi patients

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