In which patients the best efficacy of secukinumab? Update of a real-life analysis after 136 weeks of treatment with secukinumab in moderate-to-severe plaque psoriasis

Figures & data

Table 1. Demographic characteristics of the 151 patients included in the analysis.

Male sex (%)	66.4%
Age, mean ± SD (range) (y)	45.3 ± 13.8 (19–78)
Weight, mean ± SD (range) (kg)	79.8 ± 16.7
BMI, mean ± SD Normal weight (BMI < 25) Overweight (25 ≤ BMI ≤ 30) Obese (BMI > 30)	27 ± 5.3 44.5% 32.8% 22.6%
Age at disease onset, mean ± SD (range) (y)	25.1 ± 12.7 (3–62)
Duration of psoriasis, mean ± SD (range) (y)	20.5 ± 13.7 (2–59)
PASI at baseline, mean ± SD (range)	17.7 ± 11.1 (5–57)
Naïve to biological therapy (%)	81%

SD: standard deviation; BMI: body mass index; PASI: Psoriasis Area and Severity Index.

Figure 1. PASI improvement after initiation of secukinumab therapy, which is maintained throughout the 136-week observation period.

LOCF: last observation carried forward imputation; PASI: Psoriasis Area and Severity Index; w: week; y: year. (a) Changes in PASI 75, PASI 90, and PASI 100 during 136 weeks of treatment. Data are presented as percentages.(b) Changes in absolute PASI scores over 136 weeks of treatment. Average PASI values are reported for each time point. The sidebox reports the percentage of patients who reached that particular time point at the moment of the analysis.

Table 2. Univariate logistic regression analysis of variables associated with PASI75 response.

Variable	OR (95% CI)	P-value
8 weeks
Comorbidities	1.72[1.11–2.70]	0.016
NAÏVE/PBT	2.08[1.32–3.23]	0.002
Weight	0.97 [0.94–0.99]	0.010
BMI	1.11[1.03–1.2]	0.009
Normal weight	2.5[1.02–6,25]	0.045
No obesity	3.33[1.35–8.33]	0.009
16 weeks
Comorbidities	1.79[1.00–3.13]	0.050
NAÏVE/PBT	2.27[1.43–3.70]	0.001
24 weeks
Comorbidities	1.64[1.01–2.63]	0.045
NAÏVE/PBT	2.08[1.35–3.23]	0.001
40 weeks
C*06:02	4.4[1.04–18.54]	0.044
Comorbidities	1.72[1.04–2.86]	0.034
NAÏVE/PBT	2.44[1.54–3.85]	<0.001
BMI	1.12[1.02–1.23]	0.015
No obesity	3.45[1.16–10]	0.026
1 year
C*06:02	5.92[1.44–24.36]	0.014
Comorbidities	1.88 [1.14–3.23]	0.014
Age	0.94 [0.90–0.99]	0.008
NAÏVE/PBT	2.7[1.64–4.45]	<0.001
BMI	1.11[1.02–1.22]	0.022
No Obesity	4.17[1.43–12.2]	0.009
72 weeks
NAÏVE/PBT	2.78[1.59–4.76]	<0.001
88 weeks
NAÏVE/PBT	2.70[1.47–5]	0.001
2 years
NAÏVE/PBT	2.27[1.27–4.17]	0.006
120 weeks
NAÏVE/PBT	2.22[1.19–4.17]	0.012

BMI: body mass index; PASI: Psoriasis Area and Severity Index; PBT: previous biological therapy; Normal weight: patients with BMI<25; No obesity: patients with BMI≤30.

Table 3. Univariate logistic regression analysis of variables associated with PASI90 response.

Variable	OR (95% CI)	P-value
8 weeks
Comorbidities	1.82[1.16–2.78]	0.008
NAÏVE/PBT	2.27[1.32–4]	0.004
Weight	0.97 [0.94–0.99]	0.006
BMI	1.14[1.05–1.23]	0.001
Normal weight	2.63[1.25–5.56]	0.011
No obesity	4.17[1.72–10]	0.002
16 weeks
C*06:02	3.97[1.06–14.86]	0.041
Comorbidities	2.08[1.27–3.33]	0.003
NAÏVE/PBT	2.5[1.54–4.17]	<0.001
BMI	1.11[1.02–1.22]	0.017
24 weeks
C*06:02	4.21[1.16–15.31]	0.029
Comorbidities	2.08[1.27–3.33]	0.002
Age	0.96 [0.93–0.99]	0.019
NAÏVE/PBT	2.56[1.59–4.17]	<0.001
Weight	0.96 [0.94–0.99]	0.004
BMI	1.14[1.05–1.23]	0.002
Normal weight	3.13[1.16–8.33]	0.025
No obesity	3.23[1.27–8.33]	0.014
40 weeks
C*06:02	4.01[1.19–13.47]	0.025
Comorbidities	1.86[1.16–2.94]	0.009
Weight	0.96 [0.93–0.99]	0.004
NAÏVE/PBT	3.13[1.79–5.26]	<0.001
BMI	1.14[1.05–1.25]	0.003
No obesity	3.85[1.49–10]	0.005
1 year
C*06:02	5.01[1.38–18.18]	0.014
Comorbidities	2.04[1.25–3.33]	0.005
NAÏVE/PBT	3.13[1.79–5.56]	<0.001
Age	0.94 [0.91–0.98]	0.003
BMI	1.14[1.04–1.25]	0.005
Normal weight	2.86[1.02–7.69]	0.045
No obesity	3.45[1.3–9.09]	0.013
72 weeks
C*06:02	3.62[1.07–12.23]	0.038
Comorbidities	1.69[1.02–2.78]	0.041
NAÏVE/PBT	2.7[1.56–4.76]	<0.001
BMI	1.12[1.03–1.23]	0.010
Normal weight	3.45[1.15–10.52]	0.027
No obesity	4.45[1.56–12.5]	0.006
88 weeks
Comorbidities	1.82[1.01–3.23]	0.048
NAÏVE/PBT	2.13[1.23–3.45]	0.006
No obesity	3.33[1–10.75]	0.048
2 years
NAÏVE/PBT	2.5[1.32–4.76]	0.005
120 weeks
Comorbidities	2.17[1–4.76]	0.050
NAÏVE/PBT	2.78[1.32–5.88]	0.007

BMI: body mass index; PASI: Psoriasis Area and Severity Index; PBT: previous biological therapy; Normal weight: patients with BMI<25; No obesity: patients with BMI≤30.

Table 4. Univariate logistic regression analysis of variables associated with PASI100 response.

Variable	OR (95% CI)	P-value
8 weeks
C*06:02	3.43[1.06–11.04]	0.039
Comorbidities	1.92[1.14–3.23]	0.014
NAÏVE/PBT	3.70[1.27–10.64]	0.017
BMI	1.1[1.01–1.2]	0.023
Normal weight	2.38[1.15–5]	0.020
No obesity	3.03[1.12–8.33]	0.029
16 weeks
Comorbidities	2.08[1.32–3.33]	0.003
NAÏVE/PBT	2.38[1.4–4.17]	0.002
BMI	1.11[1.02–1.2]	0.015
Age	0.96 [0.94–0.99]	0.016
24 weeks
C*06:02	3.68[1.30–10.40]	0.014
Comorbidities	2.38[1.49–3.84]	<0.001
Age	0.96 [0.93–0.98]	0.002
Weight	0.96 [0.94–0.99]	0.004
NAÏVE/PBT	2.33[1.4–3.85]	0.001
BMI	1.1[1.02–1.17]	0.015
Normal weight	2.78[1.25–5.88]	0.011
40 weeks
Comorbidities	2.08[1.3–3.33]	0.002
NAÏVE/PBT	2.78[1.56–4.76]	<0.001
Age	0.95 [0.92–0.98]	0.003
Weight	0.96 [0.94–0.99]	0.004
BMI	1.13[1.05–1.23]	0.002
Normal weight	2.5[1.09–5.88]	0.031
No obesity	2.63[1.06–6.25]	0.036
1 year
C*06:02	2.89[1.00–8.34]	0.050
Comorbidities	2.04[1.25–3.33]	0.005
Age	0.95 [0.92–0.99]	0.006
NAÏVE/PBT	3.13[1.69–5.88]	<0.001
BMI	1.11[1.03–1.22]	0.010
Normal weight	2.5[1.05–5.88]	0.039
72 weeks
Comorbidities	1.85[1.14–3.04]	0.014
NAÏVE/PBT	2.38[1.34–4.17]	0.003
Age	0.95 [0.92–0.99]	0.007
BMI	1.14[1.04–1.25]	0.005
Normal weight	2.63[1.08–6.25]	0.034
No obesity	4.17[1.49–11.11]	0.006
88 weeks
NAÏVE/PBT	2.17[1.15–4.17]	0.017
No obesity	3.57[1.08–11.63]	0.038
2 years
NAÏVE/PBT	2.08[1.05–4.17]	0.035
120 weeks
Comorbidities	6.67[1.54–3.03]	0.012
NAÏVE/PBT	3.45[1.08–11.11]	0.038

BMI: body mass index; PASI: Psoriasis Area and Severity Index; PBT: previous biological therapy; Normal weight: patients with BMI<25; No obesity: patients with BMI≤30.

Table 5. Multivariate logistic regression analysis (stepwise analysis) of predictors of PASI response after treatment with secukinumab at 1 and 2 years.

Variable	OR (95% CI)	P-value
PASI 75
1 year
NAÏVE/PBT	2.70 [1.64–4.35]	<0.001
2 years
NAÏVE/PBT	2.27[1.27–4.17]	0.006
PASI 90
1 year
NAÏVE/PBT	3.70 [1.79–7.69]	<0.001
2 years
NAÏVE/PBT	2.50 [1.32–4.76]	0.005
PASI 100
1 year
NAÏVE/PBT	5.00 [1.79–14.29]	0.002
2 years
NAÏVE/PBT	2.08[1.05–4.17]	0.035

PASI: Psoriasis Area and Severity Index; PBT: previous biological therapy.

Figure 2. Patient with Down's syndrome prior to initiating secukinumab and after 104 weeks of therapy.

Figure 3. Plaque psoriasis in difficult-to-treat locations before and after initiation of secukinumab therapy.

(a) Patient with head and scalp plaques prior to initiating secukinumab and after 24 weeks of therapy. (b) Patient with nail psoriasis prior to initiating secukinumab and after 8 weeks of therapy. (c) Patient with plantar plaques prior to initiating secukinumab and after 24 weeks of therapy. (d) Patient with torso, leg, and, genital localizations at baseline and after 8 and 104 weeks of treatment.