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Short-term psoriasis clearance lowers risk for long-term secukinumab discontinuation

Long-term treatment adherence to secukinumab among patients with psoriasis appears to be favorable, with 24% of patients discontinuing treatment over the follow-up period of one study.

The retrospective study included all patients treated with secukinumab (Cosentyx, Novartis) for psoriasis in a dermatology department in Toulouse, France, between September 2011 and June 2017.

Ninety-one patients — 60 men and 31 women — were included. Of these, 85 were initially included in clinical trials evaluating secukinumab. In the OPTIMISE trial, patients were treated with secukinumab 300 mg every 2 or 4 weeks. In the PROSE trial, patients received secukinumab 300 mg every 4 weeks.

The researchers recorded patient sex, age, weight, smoking activity, previous psoriasis treatments, disease duration, characteristics of psoriasis and severity of psoriasis before treatment.

Sixty-five percent of patients smoked, and mean patient weight was 79.1 kg. The population included 84 cases of plaque psoriasis, five cases of palmoplantar pustular psoriasis and five cases of psoriatic arthritis.

Of the 22 patients who discontinued treatment, 14 ceased treatment because of loss of efficacy, five stopped treatment due to adverse events and two anticipated pregnancy. One patient was lost to follow-up.

Patients who discontinued treatment received secukinumab for a median of 25.5 weeks, whereas those who continued treatment received secukinumab for a median of 99.9 weeks.

Longer disease duration (P = .01) and palmoplantar psoriasis (P = .01) were predictive factors for treatment failure.

Short-term psoriasis improvement quality was influential in long-term outcomes, the researchers reported. Patients who achieved Psoriasis Area and Severity Index 90-100 at week 12 to 16 were less likely to discontinue treatment in the long term compared with those with less complete clearance. – by Abigail Sutton

Disclosures: Ferrières reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.