Secukinumab treatment demonstrated high drug survival and sustained effectiveness in patients with severe chronic plaque psoriasis: 21‐month analysis in Australian routine clinical practice (SUSTAIN study)

Abstract

Background Drug survival measures the rate and duration of adherence to a given therapeutic agent and evaluates its long‐term effectiveness, safety, and real‐world utility. The SUSTAIN study sought to establish the drug survival and effectiveness of secukinumab for patients with severe chronic plaque psoriasis (CPP) in the Australian clinical setting. Methods Data of all patients (aged ≥18 years) from Australasian Psoriasis Registry (APR) treated with secukinumab were analysed. The primary objective was to describe the drug survival of secukinumab at 9 months. Key secondary objectives included drug survival of secukinumab at 3, 6, 15, and 21 months, stratified by biologic‐naïve vs biologic‐experienced patients; proportion of patients achieving Psoriasis Area and Severity Index (PASI) 75/90/100 responses; and changes in health‐related quality of life over time utilising the Dermatology Life Quality Index (DLQI). Results Of 294 patients included in this analysis, 110 (37.4%) were biologic‐naïve and 184 (62.6%) biologic‐experienced. Kaplan–Meїer drug survival rates in biologic‐naïve vs biologic‐experienced patients were 0.92 vs. 0.86 (9 months) and 0.82 vs. 0.68 (21 months), respectively. The proportion of patients with PASI 75/90/100 responses for biologic‐naïve vs. biologic‐experienced was 100/87.7/38.4 vs 98.5/61.5/27.2 (9 months) and 100/81.0/41.7 vs. 98.4/62.0/24.2 (21 months), respectively. The mean (standard deviation [SD]) DLQI in biologic‐naïve vs. experienced patients was 2.2 (4.1) vs. 3.1 (5.2) (9 months) and 1.4 (2.5) vs. 3.1 (5.3) (21 months). No new safety signals were observed. Conclusions Secukinumab demonstrated high drug survival and sustained effectiveness in Australian real‐world setting, in biologic‐naïve and biologic‐experienced patients with severe CPP.

Real-world safety and effectiveness of secukinumab in adult patients with moderate to severe plaque psoriasis: results from postmarketing surveillance in Korea

“…The same is corroborated by other real-world studies, wherein higher proportion of biologic-naïve patients achieved PASI 75/90/100 responses than biologic-experienced patients. 9 , 31 The current study also demonstrated the same trend for PASI 75 and 90; however, the higher proportion of biologic-experienced patients achieved PASI 100 than biologic-naïve patients. Interestingly, a stark difference in the proportion of patients achieving PASI 100 in the biologic-naïve cohort versus biologic-experienced cohort was observed in another study from Japan.…”

“… 32 , 33 Other studies assessing the effectiveness of secukinumab on patients with psoriasis also had higher percentage of patients exposed to biologics at baseline. 9 , 34 , 35 These studies indicated much higher accessibility of biologics by the Western population compared to the Korean population.…”

“…The mean PASI was also different in patients who received secukinumab in HOPE (Australia), SUSTAIN (Australia), and DERMBIO (Denmark) studies (21.8, 13.0, and 7.3, respectively). 9 , 24 , 36 This difference might reflect differences in treatment guidelines among countries and use of biologic treatment in real-world settings. 29 In the current study, the absolute PASI (mean ± SD) score decreased from 16.1 ± 7.1 at baseline to 1.6 ± 2.4 at week 24.…”

“…These results are in line with the therapeutic outcomes (PASI, body surface area, Investigator’s Global Assessment, Dermatology Life Quality Index) of patients with psoriasis of other real-world studies conducted in the USA, Italy, and Australia. 9 , 33 , 42 …”

“…Secukinumab is a fully human monoclonal antibody that selectively neutralizes IL-17A and has proven to be effective in the treatment of multiple manifestations of psoriatic disease, including psoriasis localized to the nails, scalp, palms, soles, and joints. 9 , 10 Besides psoriatic disease, secukinumab has recently been approved by the European Commission and the U.S. Food and Drug Administration (USFDA) for the treatment of moderate to severe hidradenitis suppurativa in adults. 11 , 12 Secukinumab has shown sustained long-term efficacy and a favorable safety profile in adult patients with moderate to severe plaque psoriasis in four pivotal randomized controlled trials (RCTs).…”