Real-life experience of secukinumab injection in difficult chronic plaque-type psoriasis: a multicenter experience
GK Singh1, Rajiv Sekhri2, Manas Chatterjee3, Sukriti Baveja4, Neha Akhoon5
1 Department of Dermatology, Venereology and Leprosy, Affiliated Faculty, Armed Forces Medical College, Military Hospital, Pune, Maharashtra, India
2 Private consultant dermatology clinic, Noida, Uttar Pradesh, India
3 Department of Dermatology, Venereology and Leprosy, INHS, Mumbai, India
4 Department of Dermatology, Venereology and Leprosy, Command Hospital (SC), India
5 Department of Pharmacology, Affiliated Faculty, Armed Forces Medical College, Military Hospital, Pune, Maharashtra, India
G K Singh
Department of Dermatology, Venereology and Leprosy, Affiliated Faculty, Armed Forces Medical College, Military Hospital, Kirkee, Pune 411020
Source of Support: None, Conflict of Interest: None
Background Secukinumab, a fully human monoclonal antibody that selectively targets interleukin-17A, has been proven highly efficacious in the management of moderate to severe psoriasis with early response and sustained effects in many phase III clinical trials. However, data on real-life experience is lacking.
Patients and methods A multicentric, retrospective study in routine clinical setting was conducted in cases of chronic plaque type of psoriasis during November 2016 to December 2017. Patients who had received 300-mg secukinumab injection subcutaneously at 0, 1, 2, 3, and 4 months and then every 4 weekly for at least 6 months were recruited for the study. Assessment of severity of psoriasis was done by psoriasis area severity index (PASI) and dermatological life quality index (DLQI).
Results A total of 32 patients, comprising 24 males and 8 females, with mean age of 42.31 years (SD 11.32) and mean baseline PASI of 20.72 (SD 7.53) and DLQI of 15.31 (SD 5.25), were studied. Achievement of PASI 75/90/100 at 12 weeks was 81.25/59.37/9.3, respectively. PASI 75 at the end of 52 weeks was maintained at 65.62. DLQI reduced to 2.56 (SD 5.19) (16.72% of baseline) at the end of 12 weeks. Differences between baseline scores and each subsequent visit were statistically significant (P<0.001). Only mild adverse effects were noticed in six (18.7%) patients.
Conclusion Secukinumab is a very promising new molecule in the management of chronic plaque type of psoriasis that is resistant to conventional modalities in routine clinical setting even in an Indian scenario. A retrospective analysis, with few cases, was inherent limitation of this study.