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Cosentyx fixed-interval maintenance more effective than retreatment as needed for psoriasis

Regular dosing every 4 weeks of Cosentyx was more efficacious as a maintenance therapy compared with retreatment as needed, according to recently published study results.

Researchers conducted a double-blind study in which they randomly assigned 966 adults with moderate-to-severe plaque psoriasis to treatment with subcutaneous Cosentyx (secukinumab, Novartis) at 300 mg (n=484) or 150 mg (n=482) from baseline to week 4 and at week 8. Patients who achieved 75% or more improvement from baseline Psoriasis Area and Severity Index (PASI 75) were then randomly assigned again to retreatment with 300 mg (n=217) or 150 mg (N=206) as needed (n=217) or a fixed interval (n=203).

Noninferiority of retreatment as needed compared with fixed interval for maintaining PASI 75 to week 52 was used as primary endpoint.

High responses were reported for secukinumab by week 12, with 84.4% to 91.1% of patients achieving PASI 75. Higher percentages of patients on the fixed interval treatment between week 12 and week 52 maintained PASI 75 (78.2%, 300 mg; 62.1%, 150 mg) compared with patients on the retreatment-as-needed regimen (67.7%, 300 mg; 52.4%, 150 mg). The noninferiority primary endpoint was not established.

Overall safety was similar between regimens, which included very low incidence of antidrug antibodies in four of the 966 adults.

“The results of this study indicate that the secukinumab fixed-interval regimen is more efficacious than the assessed retreatment-as-needed regimen in maintaining long-term psoriasis control,” the researchers concluded. “The low immunogenicity observed in the retreatment-as-needed group suggest that secukinumab could be safely interrupted and readministered if necessary.” – by Bruce Thiel

Disclosure: Mrowietz served as advisor and/or received speaker honoraria and/or received grants and/or participated in clinical trials for Abbott/AbbVie, Almirall, Amgen, BASF, Biogen Idec, Celgene, Centocor, Eli Lilly, Forward Pharma, Galderma, Janssen, Leo Pharma, Medac, MSD, Miltenyi Biotech, Novartis, Pfizer, Teva, VBL and Xenoport. See the study for a full list of the other researchers’ relevant financial disclosures.