Low blood monocyte counts in psoriasis patients may predict better response to secukinumab

Key takeaways:

• In this study, patients with plaque psoriasis were evaluated 6 months after initiating treatment with secukinumab.
• Patients with lower blood monocyte counts at baseline achieved better outcomes.

Patients with plaque psoriasis that have lower baseline blood monocyte counts may respond to secukinumab therapy earlier than patients with higher counts, according to a study.

It has recently been claimed that patients who achieve PASI scores less than or equal to 2 within the first 6 months of initiating biologic treatment tend to exhibit more stable psoriasis and a lower risk of flare over the next 5 years compared with patients that have PASI scores higher than 2, according to researchers.

“Identifying the factors that affect early response to biologics could be helpful in selecting the most effective medication for patients with psoriasis and may avoid expensive switching between biologics,” Dominika Ziolkowska-Banasik, MD, of the department of internal diseases, dermatology and allergology at the Medical University of Silesia in Poland, and colleagues wrote.

To investigate the factors that may contribute to a patient improving within the first 6 months of biologic treatment for psoriasis, the authors conducted a study in which 29 biologic-naïve patients with active plaque psoriasis were treated with secukinumab.

Results showed that all patients achieved PASI scores less than 10 within 6 months after initiating therapy; however, only 15 achieved scores less than or equal to 2.

While those that achieved PASI scores less than or equal to 2 did not differ in basic demographic and clinical characteristics from those with higher scores, they consistently differed in their blood monocyte count.

More specifically, the patients that achieved PASI scores greater than 2 had a much higher baseline monocyte count than the other patients. In fact, a lower monocyte count at baseline, characterized as being less than 0.69 x 10³/L, was an independent factor for achieving a PASI score less than or equal to 2 within 6 months of initiating secukinumab therapy, according to a multivariate analysis (P = .03).

Furthermore, patients that achieved lower PASI scores after 6 months of initiating secukinumab also exhibited greater improvement within the first month of therapy vs. patients with higher PASI scores at 6 months.

“Blood monocyte count may serve as a prognostic factor for response to therapy with secukinumab, which may help to select patients who may benefit from such treatment and those who will not,” the authors concluded.