Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate-to-severe plaque psoriasis up to 1 year: Results from the CLEAR study

Blauvelt, Andrew; Reich, Kristian; Tsai, Tsen‐Fang; Tyring, Stephen K.; Vanaclocha, F.; Kingo, Külli; Ziv, Michael; Pinter, Andreas; Vender, Ronald; Hugot, Sophie; You, Ruquan; Milutinovic, M.; Thaçi, Diamant

doi:10.1016/j.jaad.2016.08.008

Cited by 274 publications

(302 citation statements)

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“…Another key feature of our findings is that the results provide critical head‐to‐head information for clinicians when considering long‐term treatment options for their psoriasis patients. Similar to efficacy data already reported,27, 28 secukinumab provided faster, greater and sustained improvements in patient‐reported daily activities and personal relationships when compared to ustekinumab. Future studies should be considered to confirm these clinical trial results using a real‐world setting in patients initiating or switching to secukinumab.…”

Section: Discussionsupporting

confidence: 84%

“…Secukinumab targets IL‐17A, a key pro‐inflammatory mediator of psoriatic inflammation, and leads to rapid and sustained clinical responses with a favourable safety profile 22, 28. While the impact of secukinumab treatment has been shown on overall skin‐related quality of life, little is known about specific aspects and even less is known in comparison to ustekinumab.…”

Section: Discussionmentioning

confidence: 99%

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Secukinumab demonstrates greater sustained improvements in daily activities and personal relationships than ustekinumab in patients with moderate‐to‐severe plaque psoriasis: 52‐week results from the CLEAR study

Blauvelt

Reich

Mehlis

et al. 2017

Acad Dermatol Venereol

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BackgroundPsoriasis can greatly impact patients’ lives by influencing clothing worn as well as by impairing sexual functioning. Secukinumab, a human monoclonal antibody selectively neutralizing interleukin‐17A, has demonstrated good efficacy and safety in the treatment of moderate‐to‐severe psoriasis and psoriatic arthritis with a rapid onset of action and sustained response.ObjectiveThis analysis using the CLEAR study, a phase 3b double‐blind study comparing the efficacy and safety of secukinumab vs. ustekinumab in adults with moderate‐to‐severe plaque psoriasis, evaluated the treatment effects on patient's daily activities and personal relationships.MethodsImpact on daily activities (interference with home/shopping/garden, and influence on clothes worn) and impact on personal relationships (problems with partner/others, and sexual difficulties) as well as their corresponding subscales were selected from the Dermatology Life Quality Index scale and evaluated for patients treated with secukinumab vs. ustekinumab from the CLEAR study. Treatment differences in mean scores and proportions of responders (score = 0, indicating no impact) were evaluated through 52 weeks. Time to response was evaluated through Week 16.ResultsSignificant differences between secukinumab and ustekinumab were observed for daily activities and personal relationships at Week 16 and sustained through Week 52 (Week 52 response rates for daily activities: 82.9% vs. 73.5%, including interference with home/shopping/garden: 88.5% vs. 78.2%, and influence on clothes worn: 85.6% vs. 74.4%; personal relationships: 86.1% vs. 73.7%, including problems with partner/others: 86.6% vs. 74.8%, and sexual difficulties: 88.5% vs. 74.3%; all P < 0.01). The median time to response was 4 weeks for secukinumab vs. 8 weeks for ustekinumab for daily activities and personal relationships (both P < 0.05).ConclusionSecukinumab treatment helps patients with moderate‐to‐severe plaque psoriasis have a more normal life faster when compared to ustekinumab, by providing greater and sustained improvement in clothing choice and sexual functioning.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Secukinumab demonstrates greater sustained improvements in daily activities and personal relationships than ustekinumab in patients with moderate‐to‐severe plaque psoriasis: 52‐week results from the CLEAR study

Blauvelt

Reich

Mehlis

et al. 2017

Acad Dermatol Venereol

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“…The disappearance of neutrophils correlates with the decrease in proliferation of keratinocytes, demonstrating a strong interaction between these cells in the immune response [12]. IL-17A is important in defense against extracellular pathogens and candidiasis has been reported in patients using SEC (cases controlled with classical treatments without systemic infection report) [6,12]. The effectiveness of SEC is greater than the UST in the treatment of plaque psoriasis [6], but rare adverse effects of SEC include neutropenia and isolated reports of Crohn's disease activation [6,12].…”

Section: Introductionmentioning

confidence: 98%

“…The inhibitors of interleukins (ustekinumab -UST and secukinumab -SEC) are more effective in the treatment of plaque psoriasis than the anti-TNF agents [4,6] as they act directly on the Interleukin (IL) -23/17 axis (the protagonist of the immunopathogenesis of psoriasis) [7]. By the way, the main mechanism of action of the anti-TNF agents in plaque psoriasis appears to be the inhibition of sTNF involved in the activation of dermal dendritic cells (which are potent sources of IL-23).…”

Section: Introductionmentioning

confidence: 99%

“…The inhibition of IL-17 by SEC (human IgG1κ monoclonal antibody that binds to soluble interleukin IL-17A) reduces the production of various chemokines by keratinocytes including the ones responsible for the arrival of neutrophils in the skin [6,12]. SEC causes rapid disappearance of neutrophils (potent sources of IL-17A) in psoriasis lesions [12].…”

Section: Introductionmentioning

confidence: 99%

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Mechanism of action of the biologics used in the treatment of plaque psoriasis

Sanchez¹

2017

CRDOA

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The biologics modified the treatment of plaque psoriasis in recent years. It is important that dermatologists know the mechanism of action of these drugs so they can better understand their indications and side effects. In this article we will discuss the mechanism of action of five biologics used in the treatment of plaque psoriasis: three anti-tumour necrosis factor agents (infliximab, adalimumab and etanercept) and two interleukin inhibitors (ustekinumab and secukinumab). 2

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Pathophysiology, Clinical Presentation, and Treatment of Psoriasis

Armstrong

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2020

JAMA

1,388

1,105

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ImportanceApproximately 125 million people worldwide have psoriasis. Patients with psoriasis experience substantial morbidity and increased rates of inflammatory arthritis, cardiometabolic diseases, and mental health disorders.ObservationsPlaque psoriasis is the most common variant of psoriasis. The most rapid advancements addressing plaque psoriasis have been in its pathogenesis, genetics, comorbidities, and biologic treatments. Plaque psoriasis is associated with a number of comorbidities including psoriatic arthritis, cardiometabolic diseases, and depression. For patients with mild psoriasis, topical agents remain the mainstay of treatment, and they include topical corticosteroids, vitamin D analogues, calcineurin inhibitors, and keratolytics. The American Academy of Dermatology-National Psoriasis Foundation guidelines recommend biologics as an option for first-line treatment of moderate to severe plaque psoriasis because of their efficacy in treating it and acceptable safety profiles. Specifically, inhibitors to tumor necrosis factor α (TNF-α) include etanercept, adalimumab, certolizumab, and infliximab. Other biologics inhibit cytokines such as the p40 subunit of the cytokines IL-12 and IL-13 (ustekinumab), IL-17 (secukinumab, ixekizumab, bimekizumab, and brodalumab), and the p19 subunit of IL-23 (guselkumab, tildrakizumab, risankizumab, and mirikizumab). Biologics that inhibit TNF-α, p40IL-12/23, and IL-17 are also approved for the treatment of psoriatic arthritis. Oral treatments include traditional agents such as methotrexate, acitretin, cyclosporine, and the advanced small molecule apremilast, which is a phosphodiesterase 4 inhibitor. The most commonly prescribed light therapy used to treat plaque psoriasis is narrowband UV-B phototherapy.Conclusions and RelevancePsoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients’ quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.

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Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate-to-severe plaque psoriasis up to 1 year: Results from the CLEAR study

Cited by 274 publications

References 21 publications

Secukinumab demonstrates greater sustained improvements in daily activities and personal relationships than ustekinumab in patients with moderate‐to‐severe plaque psoriasis: 52‐week results from the CLEAR study

Secukinumab demonstrates greater sustained improvements in daily activities and personal relationships than ustekinumab in patients with moderate‐to‐severe plaque psoriasis: 52‐week results from the CLEAR study

Mechanism of action of the biologics used in the treatment of plaque psoriasis

Pathophysiology, Clinical Presentation, and Treatment of Psoriasis

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