Patients with moderate to severe plaque psoriasis rapidly regained clear or almost clear skin, as adjudged by the Psoriasis Area Severity Index, after treatment with secukinumab (Cosentyx; Novartis) following relapse during a treatment pause.

The new findings come from an uncontrolled, extension of the ERASURE trial, which compared secukinumab with placebo, and FIXTURE trial, which compared secukinumab with placebo and etanercept. A total of 181 patients treated with secukinumab 300mg who achieved a PASI 75 response at the end of the core studies (Week 52) were re-randomized to receive placebo every 4 weeks until relapse, upon which, patients were retreated with secukinumab 300mg.

Efficacy was assessed by the reduction in the total PASI score from baseline. Results showed that the majority of patients regained a high response level after relapse (PASI 75 or higher) at 12 to 16 weeks after treatment re-initiation. For the 136 patients who previously achieved PASI 75, the analysis showed that by Week 16 of secukinumab retreatment, 94% had regained a PASI 75 response. Among prior PASI 90 responders, 79% (n=117) regained PASI 90 response and 67% of prior PASI 100 responders (n=67) regained a PASI 100 response. 

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“Importantly, we found that stopping and re-starting Cosentyx led to good re-capture of clinical responses,” said Andrew Blauvelt, MD, MBA, President of Oregon Medical Research Center and lead study investigator. “Low immunogenicity associated with Cosentyx may offer a partial explanation of these results and warrants further analysis.”

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No patients in the analysis tested positive for anti-secukinumab antibodies. The most common adverse event were nasopharyngitis (20.7 exposure adjusted Incidence Rate [IR] per 100 patient years), arthralgia (12.6 IR) and upper respiratory tract infections (12.4 IR).

Cosentyx is an interleukin-17A antagonist (IL-17A) approved for plaque psoriasis, psoriatic arthritis and ankylosing spondylitis.

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