Efficacy and Safety of Secukinumab in Chinese Patients with Moderate-to-Severe Plaque Psoriasis: A Real-Life Cohort Study
Psoriasis is a chronic inflammatory skin disorder that affects approximately 0.47% of the Chinese population. The pathogenesis of psoriasis involves interleukin (IL)-17A, a critical effector cytokine. Secukinumab, an IL-17A inhibitor, has shown efficacy in treating moderate-to-severe plaque psoriasis in clinical trials. However, real-world data on its efficacy and safety in Chinese patients are limited. This study aimed to evaluate the real-life efficacy and safety of secukinumab 150 mg and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis.
The study was conducted at Peking University People’s Hospital and included 106 adult patients diagnosed with moderate-to-severe plaque psoriasis. Patients were treated with either secukinumab 150 mg or 300 mg based on their weight, psoriasis severity, and affordability. The treatment continued for at least 24 weeks, with efficacy assessed using the Psoriasis Area and Severity Index (PASI) scores. Safety was monitored through adverse event (AE) reporting.
Of the 106 patients, 59 (55.7%) received secukinumab 300 mg, and 47 (44.3%) received secukinumab 150 mg. Baseline characteristics showed that the mean age of patients was 39.6 years, with a mean psoriasis duration of 15.7 years. The mean baseline PASI score was 17.6, indicating moderate-to-severe disease. Patients in the 300 mg group had higher mean weight (76.93 kg vs. 61.89 kg) and higher baseline PASI scores (20.12 vs. 14.34) compared to the 150 mg group.
At week 12, the secukinumab 150 mg group achieved PASI 75, PASI 90, and PASI 100 responses in 100%, 97.8%, and 95.7% of patients, respectively. These high response rates were maintained through week 24. In the secukinumab 300 mg group, PASI 75, PASI 90, and PASI 100 responses were achieved in 93.2%, 81.4%, and 76.3% of patients at week 12, and 91.5%, 86.4%, and 79.9% at week 24, respectively. Biologic-naïve patients showed better clinical efficacy compared to those with prior biologic exposure.
The safety profile of secukinumab was favorable, with 47.2% of patients experiencing at least one AE. The most common AEs were nasopharyngitis, superficial skin bacterial infections, urticaria, eczema, and upper respiratory infections. Most AEs were mild to moderate, and no serious adverse events, such as activation of tuberculosis or hepatitis B virus, were reported. Five patients discontinued treatment due to poor response, adverse events, or economic reasons.
The study demonstrated that secukinumab, at both 150 mg and 300 mg doses, induced rapid and sustained improvements in Chinese patients with moderate-to-severe plaque psoriasis. The high PASI 90 and PASI 100 response rates suggest that secukinumab is highly effective in this population. The 150 mg dose may be a cost-effective option for patients with lower weight and milder disease severity. Biologic-naïve patients had better outcomes, highlighting the importance of considering prior treatment history when selecting therapy.
In conclusion, this real-life cohort study provides valuable insights into the efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis. The findings support the use of secukinumab as an effective treatment option, with both 150 mg and 300 mg doses showing high efficacy and a favorable safety profile. Future studies with larger sample sizes and longer follow-up periods are needed to further validate these results and explore the long-term benefits of secukinumab in this population.
doi.org/10.1097/CM9.0000000000001510
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