Secukinumab demonstrates efficacy for psoriasis in patients with skin of color

Key takeaways:

• In 73% of patients with skin of color, PASI 90 was achieved with secukinumab treatment.
• Patient-reported dyspigmentation and quality of life scores were also improved.

Secukinumab was shown to be safe and efficacious in treating psoriasis in patients with skin of color, according to a study.

“Psoriasis is a chronic inflammatory disorder primarily affecting the skin and joints. It affects different racial/ethnic groups worldwide with varying prevalence,” Nour El-Kashlan, MD, of the department of dermatology at Icahn School of Medicine at Mount Sinai, and colleagues wrote.

Despite psoriasis causing greater psychosocial impact and worse quality of life (QOL) in Black and Hispanic patients compared with white patients and differences in presentation among different skin types, biologic use for psoriasis in skin of color is under researched.

“As the U.S. and global population becomes increasingly diverse, it is increasingly important to have clinical trials that include populations that have been historically under-represented in dermatologic research,” the authors wrote. “We believe that such efforts are an important path toward promoting equity in dermatology care.”

Secukinumab, a monoclonal interleukin-17A antagonist, has previously shown efficacy in the treatment of moderate to severe plaque psoriasis including QOL, itch, pain and scaling improvements.

Twenty patients with Fitzpatrick skin types IV, V and VI and moderate to severe plaque psoriasis were enrolled in this single-center, open-label study. Each patient received weekly doses of 300 mg secukinumab for 4 weeks, followed by additional injections every 4 weeks through week 20.

A 90% improvement in PASI scores from baseline was reported in 11% of patients at week 4, 69% at week 12, 73% at week 16 and 61% at week 24. PASI 75 was achieved by 39% at week 4, 92% at week 12 (P = .002), 93% at week 16 (P = .001) and 78% at week 24 (P = .02). PASI 100 was achieved by 0%, 46%, 53% and 44% at weeks 4, 12, 16 and 24, respectively.

IGA scores of clear or almost clear (0 or 1) occurred in 85% at week 12 (P = .01), 87% at week 16 (P = .004) and 72% at week 24 (P < .048) compared with baseline.

An improvement of at least 75% in the IGA and body surface area score occurred in all patients.

DLQI scores were reduced by 11.46 at week 12, 11.4 at week 16 and 10.94 at week 24 compared with baseline, with 44% of patients reporting a DLQI score of 0 or 1 at week 24.

Changes in the patient-reported dyspigmentation VAS compared with week 4 were 0.17 at week 12, –1.54 at week 16 and –1.27 at week 24. At week 24, this difference was –1.64 compared with week 12.

“Secukinumab 300 mg administered subcutaneously is a safe, well-tolerated and viable treatment option for the management of moderate to severe plaque psoriasis in skin of color patients,” the authors wrote. “Given the paucity of data with regards to the use of biologic medications in skin of color patients, our study provides additional data where more is needed and provides important insight into treating [skin of color] populations with the inclusion of psoriasis-associated dyspigmentation as a secondary endpoint.”