Comment on “Secukinumab drug survival in patients with psoriasis: A multicenter, real-world, retrospective study”

Real-world treatment patterns and healthcare costs of biologics and apremilast among patients with moderate-to-severe plaque psoriasis by metabolic condition status

“…The higher rates of discontinuation and related outcomes among patients with metabolic conditions in this study are consistent with the recent finding that psoriasis patients with metabolic syndrome have reduced biologic drug survival over time compared with patients without this comorbidity (14)(15)(16). Although the reasons for this association are not yet clear, anti-TNF-a and IL-17 biologics have shown reduced efficacy in patients with a higher body mass index (13,24).…”

“…This study examined treatment patterns among psoriasis patients over a period longer than 12 months, enabling us to show that all of the examined outcomes became progressively worse over time, from 12 to 24 months. Our findings add to the growing literature indicating that adherence and persistence with the currently used biologics and apremilast may be problematic over the long term (17,18), particularly in patients with metabolic conditions (14)(15)(16).…”

“…The anti-IL-17 agent secukinumab had lower adherence and higher discontinuation and switching rates than ustekinumab, suggesting that anti-IL-17 agents and anti-IL-23 agents may produce different treatment effects by targeting different sites on the immune axis. In post-hoc analyses and real-world data, secukinumab has reduced long-term drug survival in obese patients and reduced efficacy in patients with metabolic syndrome, diabetes, and hypertension (13)(14)(15). On the other hand, the anti-IL-23 agent tildrakizumab is comparably effective in terms of PASI 75, 90, and 100 rates in patients with and without metabolic syndrome, indicating that anti-IL-23 agents might be a good option for psoriasis patients with metabolic abnormalities (28).…”

“…Although few data on the effects of biologic treatments in patients with metabolic syndrome are available, studies are beginning to indicate that the presence of metabolic syndrome may reduce the rate of Psoriasis Area and Severity Index (PASI) response following treatment with anti-TNF-a and IL-17 agents (12,13). In addition, psoriasis patients with metabolic syndrome have reduced long-term drug survival of biologic treatments, including adalimumab, etanercept, secukinumab, and ustekinumab (14)(15)(16).…”

Reply to: “Comment on ‘Secukinumab drug survival in patients with psoriasis: A multicenter, real-world, retrospective study’”

“…To the Editor: We thank Palacios-Garc ıa et al 1 for their interest in our study 2 and for reporting another real-world experience with secukinumab drug survival (DS). DS is emerging as a crucial factor for selecting biologic therapies for the treatment of psoriasis.…”