P78: Secukinumab treatment results in sustained improvement in absolute Psoriasis Area and Severity Index and Dermatological Life Quality Index in biologic-naïve and biologic-experienced patients with moderate-to-severe plaque psoriasis: analysis of 12 months of follow-up data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)

Jenny Hughes,¹ Laura Savage,^2,3 Emma Riley⁴ and Vivek Derodra⁴

¹Princess of Wales Hospital, Bridgend, UK; ²University of Leeds, Leeds, UK; ³Chapel Allerton Hospital, Leeds, UK; and ⁴Novartis Pharmaceuticals UK Ltd, London, UK

Secukinumab is a fully human anti-interleukin-17A monoclonal antibody for the treatment of moderate-to-severe plaque psoriasis. In a previous analysis of the ongoing longitudinal British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR; data cutoff 31 August 2020), 74.9% (n = 289) of biologic-naïve and 44.8% (n = 301) of biologic-experienced patients with psoriasis achieved an absolute Psoriasis Area and Severity Index (aPASI) score ≤ 2 after 12 months of secukinumab treatment. In this updated analysis, we report effectiveness and quality-of-life scores using aPASI and Dermatology Life Quality Index (DLQI) for a larger cohort of biologic-naïve and biologic-experienced patients with psoriasis treated with secukinumab (data cutoff 31 August 2021). Patients prescribed secukinumab at baseline (biologic-naïve) or after switching therapies during follow-up (biologic-experienced) were included. Baseline PASI and DLQI scores were reported within 6 months of secukinumab initiation (–183 to 0 days). aPASI and DLQI scores were then recorded after 4–8 and 10–14 months for the 6- and 12-month timepoints, respectively. Data from 2850 patients, 949 biologic-naïve and 1901 biologic-experienced, were analysed. Mean duration of follow-up was 2.9 years for biologic-naïve and 2.7 years for biologic-experienced patients; the majority were male (61.3% and 55.6%, respectively) and mean age was 46.5 and 45.1 years, respectively. Mean age of disease onset was 25.6 and 23.7 years, mean disease duration was 20.9 and 21.4 years, mean baseline PASI scores were 15.5 and 13.0, and mean baseline DLQI scores were 17.6 and 16.0 for biologic-naïve and biologic-experienced patients, respectively. Fewer biologic-naïve patients had psoriatic arthritis (21.2% vs. 33.2%) and had received prior ciclosporin (50.1% vs. 60.1%). Prior methotrexate use was similar between subgroups (74.3% vs. 76.8%). Almost half (46.4%) of biologic-experienced patients had received only one prior biologic (second-line secukinumab), for 32.9%, secukinumab was their third biologic and 20.7% had been treated with ≥ 4 other biologics. A higher proportion of biologic-naïve patients achieved aPASI ≤ 2 at 6 and 12 months (77.7% and 75.9%) than biologic-experienced patients (53.0% and 46.8%). DLQI scores of 0/1 after 6 and 12 months were achieved in a higher proportion of biologic-naïve (60.2% and 63.4%) than biologic-experienced patients (43.1% and 40.7%). Secukinumab treatment resulted in sustained improvement in a large proportion of patients with moderate-to-severe plaque psoriasis and nearly half of hard-to-treat biologic-experienced patients had aPASI scores ≤ 2 after 12 months. The proportion of patients with favourable outcomes (aPASI ≤ 2, DLQI 0/1) was higher in biologic-naïve than biologic-experienced patients, highlighting the importance of initiating the right treatment at the right time.

Funding sources: study funded by Novartis.