ECLIPSE trial: skin clearance independent of PsA status at baseline

Patients with and without psoriatic arthritis (PsA) at baseline have a similar benefit from treatment with secukinumab and guselkumab at 48 weeks, as was demonstrated in a new analysis of the phase 3 ECLIPSE trial [1].

The ECLIPSE trial compared the anti-IL-23 monoclonal antibody guselkumab head-to-head with the IL-17A blocker secukinumab for the treatment of moderate-to-severe plaque psoriasis. The primary endpoint of the ECLIPSE trial was the proportion of patients achieving a Psoriasis Area and Severity Index (PASI) 90 at week 48. In the overall study population, a significantly greater proportion of patients in the guselkumab group achieved this primary endpoint compared with the secukinumab group. This result was published earlier this year [2].

In the current analysis, proportions of patients at week 48 achieving PASI 90, PASI 100, Investigator’s Global Assessment (IGA) score 0/1 (clear or almost clear skin), and IGA score 0 (clear skin) responses were analysed by self-reported PsA status. The data was analysed using non-responder imputation, meaning that patients with missing data were considered non-responders.

At baseline, 18.2% of patients (97/534) in the guselkumab group reported PsA compared with 15.4% (79/414) in the secukinumab group. A greater percentage of patients treated with guselkumab achieved PASI 90 and PASI 100 response at week 48 in both PsA and non-PsA subgroups: 82.5% of patients with PsA at baseline treated with guselkumab reached PASI 90 compared with 63.3% in secukinumab treated patients. The corresponding numbers in the group without PsA were 84.9 and 71.3%, respectively. However, these differences failed to achieve statistical significance.

In addition, a similar percentage of patients reached IGA 0/1 score with both therapies: 58.8% of patients in the guselkumab group with PsA reached clear skin compared with 45.6% of patients in the secukinumab groups. In the patients without PsA, 62.9% reached an IGA 0 score with guselkumab compared with 51.3% in the secukinumab group. Safety findings were generally consistent with observations from the registrational trials of these agents.

1. Reich K, et al. P15188, AAD Virtual Meeting Experience, 12-14 June 2020.
2. Reich K, et al. Lancet 2019;394:831-839.

Posted on 7 August 202015 February 2024