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      Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate‐to‐severe psoriasis through 5 years of treatment (SCULPTURE Extension Study)

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          Abstract

          Background

          Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL‐17A, has been shown to have significant efficacy and a favourable safety profile in the treatment of moderate‐to‐severe psoriasis and psoriatic arthritis.

          Objective

          To assess the efficacy and safety of secukinumab through 5 years of treatment in moderate‐to‐severe psoriasis.

          Methods

          In the core SCULPTURE study, Psoriasis Area and Severity Index ( PASI) 75 responders at Week 12 continued receiving subcutaneous secukinumab until Year 1. Thereafter, patients entered the extension phase and continued treatment as per the core trial. Treatment was double‐blinded until the end of Year 3 and open‐label from Year 4. Here, we focus on the 300 mg fixed‐interval (every 4 weeks) treatment, the recommended per label dose. Efficacy data are primarily reported as observed, but multiple imputation ( MI) and last observation carried forward ( LOCF) techniques were also undertaken as supportive analyses.

          Results

          At Year 1, 168 patients entered the extension study and at the end of Year 5, 126 patients completed 300 mg (every 4 weeks) treatment. PASI 75/90/100 responses at Year 1 (88.9%, 68.5% and 43.8%, respectively) were sustained to Year 5 (88.5%, 66.4% and 41%). PASI responses were consistent regardless of the analysis undertaken (as observed, MI, or LOCF). The average improvement in mean PASI was approximately 90% through 5 years compared with core study baseline. DLQI (dermatology life quality index) 0/1 response also sustained through 5 years (72.7% at Year 1 and 65.5% at Year 5). The safety profile of secukinumab remained favourable, with no cumulative or unexpected safety concerns identified.

          Conclusion

          Secukinumab 300 mg treatment delivered high and sustained levels of skin clearance and improved quality of life through 5 years in patients with moderate‐to‐severe psoriasis. Favourable safety established in the secukinumab phase 2/3 programme was maintained through 5 years.

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          Most cited references17

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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.

          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).
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            Effects of AIN457, a fully human antibody to interleukin-17A, on psoriasis, rheumatoid arthritis, and uveitis.

            Interleukin-17A (IL-17A) is elaborated by the T helper 17 (T(H)17) subset of T(H) cells and exhibits potent proinflammatory properties in animal models of autoimmunity, including collagen-induced arthritis, experimental autoimmune encephalomyelitis, and experimental autoimmune uveitis. To determine whether IL-17A mediates human inflammatory diseases, we investigated the efficacy and safety of AIN457, a human antibody to IL-17A, in patients with psoriasis, rheumatoid arthritis, and chronic noninfectious uveitis. Patients with chronic plaque-type psoriasis (n = 36), rheumatoid arthritis (n = 52), or chronic noninfectious uveitis (n = 16) were enrolled in clinical trials to evaluate the effects of neutralizing IL-17A by AIN457 at doses of 3 to 10 mg/kg, given intravenously. We evaluated efficacy by measuring the psoriasis area and severity index (PASI), the American College of Rheumatology 20% response (ACR20) for rheumatoid arthritis, or the number of responders for uveitis, as defined by either vision improvement or reduction in ocular inflammation or corticosteroid dose. AIN457 treatment induced clinically relevant responses of variable magnitude in patients suffering from each of these diverse immune-mediated diseases. Variable response rates may be due to heterogeneity in small patient populations, differential pathogenic roles of IL-17A in these diseases, and the different involvement or activation of IL-17A-producing cells. The rates of adverse events, including infections, were similar in the AIN457 and placebo groups. These results support a role for IL-17A in the pathophysiology of diverse inflammatory diseases including psoriasis, rheumatoid arthritis, and noninfectious uveitis.
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              Secukinumab retreatment-as-needed versus fixed-interval maintenance regimen for moderate to severe plaque psoriasis: A randomized, double-blind, noninferiority trial (SCULPTURE).

              Secukinumab has demonstrated high, sustained efficacy in psoriasis to 52 weeks on a fixed-interval regimen.
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                Author and article information

                Contributors
                rbissonnette@innovaderm.ca
                Journal
                J Eur Acad Dermatol Venereol
                J Eur Acad Dermatol Venereol
                10.1111/(ISSN)1468-3083
                JDV
                Journal of the European Academy of Dermatology and Venereology
                John Wiley and Sons Inc. (Hoboken )
                0926-9959
                1468-3083
                22 March 2018
                September 2018
                : 32
                : 9 ( doiID: 10.1111/jdv.2018.32.issue-9 )
                : 1507-1514
                Affiliations
                [ 1 ] Innovaderm Research Montreal QC Canada
                [ 2 ] Department of Dermatology University of Münster Münster Germany
                [ 3 ] Comprehensive Center for Inflammation Medicine University Hospital Schleswig‐Holstein Lübeck Germany
                [ 4 ] Department of Geriatric and Environmental Dermatology Probity Medical Research Windsor and XLR8 Medical Research Windsor ON Canada
                [ 5 ] Novartis Pharma AG Basel Switzerland
                [ 6 ] Beijing Novartis Pharma Co. Ltd. Shanghai China
                [ 7 ] Department of Dermatology Saint Louis University Health Science Center St Louis MO USA
                [ 8 ] Department of Dermatology Psoriasis‐Center University Medical Center Schleswig‐Holstein Kiel Germany
                Author notes
                [*] [* ]Correspondence: R. Bissonnette. E‐mail: rbissonnette@ 123456innovaderm.ca
                Author information
                http://orcid.org/0000-0002-9539-0712
                Article
                JDV14878
                10.1111/jdv.14878
                6175198
                29444376
                3ddee67b-e26f-4d6f-9c84-26a79a992901
                © 2018 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 04 November 2017
                : 29 January 2018
                Page count
                Figures: 10, Tables: 2, Pages: 8, Words: 5071
                Funding
                Funded by: Novartis Pharma AG, Basel, Switzerland.
                Categories
                Original Article
                Psoriasis
                Custom metadata
                2.0
                jdv14878
                September 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.0 mode:remove_FC converted:08.10.2018

                Dermatology
                Dermatology

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