An analysis of psoriasis patients with comorbidities included in four phase 3 trials showed that secukinumab exhibits a comparable efficacy and safety in patients with comorbidities at baseline .
Today, psoriasis is seen as a chronic inflammatory systemic disease. Research has shown that different comorbidities commonly found in patients with psoriasis, such as arthritis, depression, inflammatory bowel disease, and cardiovascular diseases, are directly related to the chronic inflammatory status of psoriasis, and may thus influence efficacy and safety of drug treatment .
The IL-17 blocker secukinumab has demonstrated long-lasting efficacy and safety in the complete spectrum of manifestations of psoriatic disease. An analysis of pooled data from four phase 3 trials (i.e. ERASURE, FIXTURE, FEATURE, and JUNCTURE) assessed the incremental burden of comorbidities on clinical efficacy and safety among patients with moderate-to-severe psoriasis.
A total of 880 patients with baseline comorbidities were included in the analysis. Patients suffered from cardiovascular diseases (i.e. hypertension, angina, myocardial infarction, congestive heart failure, coronary artery disease, and cardiac arrhythmias), metabolic diseases (i.e. obesity, hyperlipidaemia, and diabetes), and musculoskeletal diseases (i.e. osteoarthritis, rheumatoid arthritis, and psoriatic arthritis), and psychiatric disease (i.e. depression).
At week 12, patients treated with secukinumab (150 mg or 300 mg) were more likely to achieve Psoriasis Area and Severity Index (PASI) 75, PASI 90, and clear or almost clear skin according to the IGA (0/1 Score) compared with those receiving placebo or etanercept (see Figure; P<0.05 for all comparisons). More patients treated with secukinumab than with placebo achieved PASI 100 and IGA 0 responses. Reassuringly, despite their comorbidities, patients did not suffer more frequently from treatment-emergent adverse events, serious adverse events, and treatment-emergent adverse events leading to study discontinuation compared with patients without comorbidities. No new safety signals were identified.
This post-hoc analysis showed that treatment with secukinumab significantly improved clinical outcomes and was well tolerated in a cohort of patients with moderate-to-severe psoriasis and active baseline comorbid conditions.
Figure: Week 12 efficacy outcomes among patients with psoriasis and baseline comorbidities 
IGA, Investigator’s Global Assessment; PASI, Psoriasis Area and Severity Index.
- Gottlieb AB, et al. Abstract No. FC02.05, EADV 2019, 9-13 Oct, Madrid, Spain.
- Paim de Oliveira M, et al. An Bras Dermatol 2015;90:9-20.
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Table of Contents: EADV 2019
Letter from the Editor
IL-17A blocker effective in paediatric psoriasis patients
Rituximab beats mycophenolate mofetil in pemphigus vulgaris
Novel JAK1/2 inhibitor shows remarkable efficacy in alopecia areata
Acne highly influenced by climate, pollutants, and unhealthy diet
JAK inhibition plus TCS lead to high clearance rates in AD
No cancer risk with long-term use of tacrolimus, a topical calcineurin inhibitor, in children with AD
Green light for a second JAK inhibitor in AD
Topical ruxolitinib effective in vitiligo
Small molecules: interesting novel treatment options in AD
IL-1⍺ blockade: a new treatment option in AD
IL-4/IL-13 blockade leads to rapid itch reduction in adolescents
How to manage conjunctivitis in AD patients treated with a biologic
Biologics: increasingly used in paediatric dermatology
Spotlight on Psoriasis
IL-17 blocker: effective and safe in patients with comorbidities
ESPRIT registry: sharp decline in mortality in patients treated with a TNF blocker
Relationship psoriasis and NAFLD: new data on the hepato-dermal axis
Novel selective IL-23 blocker equally effective in patients with metabolic syndrome
Selective IL-23 blocker crushes fumaric acids in all assessed efficacy endpoints
No hint of teratogenicity through ixekizumab
New Insights in Photoprotection
Systemic photoprotection: a valuable addition to topical sun protection
The underestimated effect of visible light
Comorbidities more common in chronic urticaria, psoriasis, and AD
D-Dimer as future biomarker in CSU management?
Ligelizumab for CSU: symptom control and high response rates in re-treatment
Rosacea – From New Spectrum to New Therapy
New guidance on rosacea therapy according to phenotype
Best of the Posters
Above-the-neck melanoma more prone to metastases
Reduced sleep quality in dermatoses influenced by itch and pain
Anxiety and depression are common in families of AD infants
Certolizumab pegol efficacious for head and neck psoriasis
Potential role of inflammation in cardiovascular comorbidity