Secukinumab More Effective Than Other Biologics for Psoriasis Treatment

Secukinumab is more effective than ustekinumab and adalimumab for treating psoriasis, according to study results published in The Journal of Investigative Dermatology.

Researchers conducted a nationwide study of patients (N=3158) with psoriasis identified from a national registry. Participants included in the study were treated with biologic medications such as adalimumab (n=1985), guselkumab (n=106), ixekizumab (n=258), secukinumab (n=852), and/or ustekinumab (n=1476) to examine their real-world performance in the treatment of psoriasis. The participants were divided into main analysis and sensitivity analysis groups. The primary endpoint was a composite of either off-label dose escalation or discontinuation of treatment. The secondary outcomes included dose escalation and discontinuation.

Compared with ustekinumab, secukinumab had a lower risk for the composite endpoint of either off-label dose escalation or medication discontinuation for secukinumab (hazard ratio [HR], 0.66; 95% CI, 0.59-0.76). However, adalimumab had a higher risk for the composite endpoint (HR 1.15; 95% CI, 1.05-1.26).

Among all of the treatments included in the study, ustekinumab had the highest risk for requiring a higher dosage. Within the first 20 weeks of treatment, 11.2% of participants needed a higher dosage, which increased to 35% after 120 weeks. Conversely, secukinumab had the lowest risk for requiring a higher dosage.

The likelihood of stopping treatment was greater for secukinumab (HR 1.24; 95% CI, 1.08-1.42) and adalimumab (HR, 2.01; 95% CI, 1.82-2.22) compared with other treatments, especially for participants who had not received biologic drugs before.

Limitations of the study include lower follow-up and fewer patients for secukinumab in the main population and guselkumab in the sensitivity population. To create a proxy for treatment failure, it may be necessary to consider additional measures besides dose escalation and discontinuation. Missing data in the study could have also impacted the results.

The researchers concluded, “In this nationwide study of patients with psoriasis who were treated with biologics, secukinumab was associated with the lowest risk of the composite endpoint of either off-label dose escalation or discontinuation, which decreased further in bio-naive patients.”

This article originally appeared on Dermatology Advisor