A study into two doses of the drug secukinumab for the treatment of psoriasis in people for whom ANTI TNF biologics have not been successful.

Psoriasis is a common skin condition affecting approximately 2% of the population, with up to 1.8 million people affected in the U.K. alone. This article reports the work from a group of U.K. and Republic of Ireland based researchers who set out to determine if secukinumab, a medicine known as an IL‐17A inhibitor, was safe and effective in patients with moderate/severe chronic plaque psoriasis for whom previous treatment with a medicine called a TNFα inhibitor had not remained effective. 53 dermatology centres in the U.K. and Republic of Ireland took part. Patients were randomly assigned to to receive secukinumab at a dose of either 300mg or 150 mg subcutaneously (by injection) every week for 4 weeks, then 4‐weekly thereafter. The Psoriasis Area Severity Index (PASI) is used to record the redness, thickness and scaling of a patient's psoriasis and to measure how well a treatment works, as a reduction in the PASI score means a reduction in these symptoms. If a patient achieves PASI 75, it means they had a 75% or more reduction in their PASI score from the start. In total, 233 patients were analysed. 77 of 118 patients (65·3%) in the 300mg dose group and 51 of 115 patients (44·3%) in the 150mg dose group had achieved PASI 75 at week 16. After 72 weeks of treatment, 77.1% of patients in the 300 mg group who remained on that treatment throughout the study achieved PASI 75. Improvements in patients' quality of life were also seen at week 16 and were maintained to week 72. The safety profile of secukinumab was generally consistent with previous secukinumab studies, although a higher incidence of some adverse events, meaning unwanted side effects, were observed (e.g. candida infections, a type of fungal infection). This study has shown evidence of the efficacy and safety of secukinumab for treatment of psoriasis patients for whom prior TNFα‐inhibitor therapy has not been effective. Linked Article: Warren et al. Br J Dermatol 2020; 183:60–70. [ABSTRACT FROM AUTHOR]