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IL-17 blocker: effective and safe in patients with comorbidities

Presented by
Dr Alice Gottlieb, Tufts University School of Medicine, USA
EADV 2019
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 [1].

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 [2].

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 [1]IGA, Investigator’s Global Assessment; PASI, Psoriasis Area and Severity Index.

    1. Gottlieb AB, et al. Abstract No. FC02.05, EADV 2019, 9-13 Oct, Madrid, Spain.
    2. Paim de Oliveira M, et al. An Bras Dermatol 2015;90:9-20.


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