Abstract

Abstract Secukinumab is a fully human anti-interleukin-17A monoclonal antibody approved for the treatment of moderate-to-severe plaque psoriasis in adults, adolescents and children aged ≥ 6 years. The British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) is an ongoing prospective observational registry that collects long-term data from patients receiving biologics for psoriasis in the UK and the Republic of Ireland. We report the clinical effectiveness, drug survival and patient-reported outcomes of secukinumab treatment in patients from BADBIR with psoriasis with and without scalp involvement. Patients aged ≥ 18 years who had one or more follow-up visit(s) after enrolment in BADBIR and were receiving secukinumab according to label (300 mg weekly loading dose for 5 weeks, followed by monthly dosing) were included (data cutoff 31 August 2021). Baseline Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores recorded between 4 and 8 months and 10 and 14 months of secukinumab initiation were used as 6- and 12-month time points, respectively. Overall mean drug survival was calculated at 12, 24 and 36 months for patients with and without scalp involvement. Outcomes of interest were the proportion of patients with PASI scores of ≤ 2 and DLQI scores of 0/1. Drug survival up to 36 months (Kaplan–Meier method) was defined as the duration between the date of first exposure to secukinumab and date of stopping secukinumab or the end of the study censoring period. The analysis included 1298 patients with psoriasis with scalp (n = 883; 68.0%) and without scalp (n = 415; 32.0%) involvement. The mean duration of follow-up was 2.9 and 2.8 years in patients with and without scalp involvement, respectively. The majority were male (60.4% and 61.5%), mean age was 45.9 and 49.5 years, mean age at disease onset was 24.7 and 26.8 years, mean baseline PASI scores were 15.2 and 14.5, and mean baseline DLQI scores were 17.4 and 17.0 in patients with and without scalp involvement, respectively. Overall, the drug survival rates at 12, 24 and 36 months were 86%, 73% and 63% and 86%, 77% and 69% in patients with psoriasis with and without scalp involvement, respectively. At 6 and 12 months of treatment, 73.9% and 70.4% and 72.1% and 68.4% of patients with and without scalp involvement, respectively, achieved PASI scores ≤ 2. At 6 and 12 months of treatment, 56.9% and 59.2% and 52.0% and 55.4% of patients with and without scalp involvement, respectively, achieved DLQI scores of 0/1. This analysis of real-world data from BADBIR shows that treatment with secukinumab resulted in high drug survival and sustained and consistent improvements in PASI and DLQI in most patients with psoriasis with and without scalp involvement.

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