Secukinumab: Fewer jabs do the job in psoriasis

New data presented at EADV 2021 support the efficacy of secukinumab 300-mg dose in a 2-mL autoinjector compared with two 150 mg in 1 mL prefilled syringes or placebo for psoriasis, with no new safety signals observed within 52 weeks.

Secukinumab 300-mg injections achieved a high efficacy, with an added benefit of convenient administration, in adults with moderate-to-severe plaque psoriasis as measured with the Psoriasis Area and Severity Index (PASI) 75 and 90 vs placebo in the randomized, placebo-controlled phase IIIb MATURE trial. [EADV 2021, abstract A2325]

PASI 90 is the new standard endpoint for randomized controlled trials of biologics for psoriasis, whereas treatment guidelines often still refer to PASI 75.

The challenge in psoriasis

Principal author for the MATURE trial, Dr Bardur Sigurgeirsson from the University of Iceland, in Reykjavik, Iceland, said psoriasis can be “difficult to manage and adherence to treatments can be a challenge” for many patients.

Secukinumab is a human IgG1 monoclonal antibody that selectively binds to the interleukin-17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor, which is thought to reduce inflammation in psoriasis.

Sigurgeirsson and his team sought to compare secukinumab 300 mg in an autoinjector vs 2 doses of secukinumab 150 mg in 1 mL pre-filled syringes or placebo in the MATURE trial.

Convenient and simple

“Our data show that secukinumab 300 mg can be delivered in one injection, making it more convenient and simpler for patients to use, without compromising efficacy or safety,” Sigurgeirsson reported at EADV 2021.

The study included 122 patients – 41 received secukinumab 300-mg/2 mL autoinjector, 41 received secukinumab in two 150-mg/1 mL pre-filled syringes, and 40 were given the placebo. Treatment was for 52 weeks. At week 12, PASI 90 nonresponders in the placebo group were switched to secukinumab.

At week 12, 95.1 percent of patients in the 300-mg autoinjector arm achieved PASI 75 vs 83.3 percent of those in the 150-mg syringes arm and 10 percent in the placebo arm. Results were comparable at week 12, with 75.6 percent of patients in the 300-mg autoinjector arm, 62.6 percent in the 150-mg prefilled syringes arm, and 10 percent in the placebo arm achieving PASI 90.

At week 52, 92.7 percent and 73.2 percent of patients treated with the secukinumab 300-mg autoinjector achieved PASI 75 and PASI 90, respectively, compared with 90.4 percent and 68.3 percent, respectively, in patients treated with two 150-mg pre-filled syringes, and 26.8 percent and 0 percent in those given the placebo.

Patient satisfaction with the 300-mg autoinjector was high. The safety profile was consistent with previous studies and no new safety signals were observed with secukinumab, said Sigurgeirsson. Similarly, the quality-of-life scores were higher with secukinumab (71.1 percent with the autoinjector and 72.5 percent with the pre-filled syringes) than with placebo (8.1 percent) users.

Patients with psoriasis can now better manage their symptoms using fewer injections, said Sigurgeirsson.