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      Secukinumab in the treatment of psoriasis: patient selection and perspectives

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          Abstract

          Secukinumab is a human monoclonal antibody targeting IL-17A that has been approved for three indications: moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. In Phase III clinical trials for each of these three indications, secukinumab has proven to be both highly efficacious and well-tolerated. However, several biologic medications are currently approved for the treatment of moderate-to-severe plaque psoriasis, and many demonstrate excellent efficacy and safety. Due to this wide selection, it is often unclear how to choose biologics for specific patients. Important considerations in biologic selection include clinical efficacy, safety, cost, convenience, onset of action, and management of comorbid disease. This article aims to outline the key considerations in patient selection for the treatment of plaque psoriasis with secukinumab.

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          Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial.

          Diamant Thaçi, Andrew Blauvelt, Kristian Reich … (2015)
          Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, has shown superior efficacy to etanercept with similar safety in moderate to severe plaque psoriasis (FIXTURE study).
          Article 0 comments Cited 202 times – based on 0 reviews     Review now
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            The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study.

            Paul Crits-Christoph, Joel Gelfand, Shanu K Kurd … (2010)
            To determine the incidence of depression, anxiety, and suicidality in patients with psoriasis compared with the general population. A population-based cohort study using data collected as part of patient's electronic medical record from 1987 to 2002. General Practice Research Database. Analyses included 146 042 patients with mild psoriasis, 3956 patients with severe psoriasis, and 766 950 patients without psoriasis. Five controls without psoriasis were selected from the same practices and similar cohort entry dates as patients with psoriasis. Clinical diagnoses of depression, anxiety, and suicidality among patients. The adjusted hazard ratios (HRs) for receiving a diagnosis of depression, anxiety, and suicidality in patients with psoriasis compared with controls were 1.39 (95% confidence interval [CI], 1.37-1.41), 1.31 (95% CI, 1.29-1.34), and 1.44 (95% CI, 1.32-1.57), respectively. The adjusted HR of depression was higher in severe (HR, 1.72; 95% CI, 1.57-1.88) compared with mild psoriasis (HR, 1.38; 95% CI, 1.35-1.40). Younger patients with psoriasis had elevated HRs of outcomes compared with older patients with psoriasis. Patients with psoriasis have an increased risk of depression, anxiety, and suicidality. We estimate that in the United Kingdom, in excess of 10 400 diagnoses of depression, 7100 diagnoses of anxiety, and 350 diagnoses of suicidality are attributable to psoriasis annually. It is important for clinicians to evaluate patients with psoriasis for these conditions to improve outcomes. Future investigation should determine the mechanisms by which psoriasis is associated with psychiatric outcomes as well as approaches for prevention.
            Article 0 comments Cited 170 times – based on 0 reviews     Review now
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              Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE).

              A Blauvelt, J C Prinz, A B Gottlieb … (2015)
              Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, demonstrated efficacy and safety in moderate-to-severe plaque psoriasis when administered via subcutaneous injection. Self-administration by pre-filled syringe (PFS) can offer patients clinical benefits of a drug, with increased convenience.
              Article 0 comments Cited 121 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Psoriasis (Auckl)
                Journal ID (iso-abbrev): Psoriasis (Auckl)
                Journal ID (publisher-id): Psoriasis: Targets and Therapy
                Title: Psoriasis: Targets and Therapy
                Publisher: Dove Medical Press
                ISSN (Electronic): 2230-326X
                Publication date Collection: 2018
                Publication date (Electronic): 17 October 2018
                Volume: 8
                Pages: 75-82
                Affiliations
                [1 ]Department of Dermatology, University of California San Francisco, San Francisco, CA, USA, ericjyang@ 123456outlook.com
                [2 ]Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA, ericjyang@ 123456outlook.com
                Author notes
                Correspondence: Eric J Yang, Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA, Tel +1 858 322 5414, Fax +1 415 502 4126, Email ericjyang@ 123456outlook.com
                Article
                Publisher ID: ptt-8-075
                DOI: 10.2147/PTT.S146004
                PMC ID: 6202001
                PubMed ID: 30425963
                SO-VID: 2548e7bf-d12c-487d-84be-c17042dbbb67
                Copyright © © 2018 Yang et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed

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                Subject: Review

                Keywords: secukinumab,il-17 inhibitor,il-17a,biologics,psoriasis,patient selection
                Data availability:
                Keywords: secukinumab, il-17 inhibitor, il-17a, biologics, psoriasis, patient selection

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