Bhat Ramesh M, Leelavathy B, Aradhya Sacchidanand S, Gopal Maragondanahalli G, Pratap D V S, Mubashir Mir, Srinivas Putta, Pande Sushil Y, Thavkar Amit S
Department of Dermatology, Father Muller Medical College, Mangalore, India.
Diabetes and Shridi Skin Care Centre, Bengaluru, India.
Indian Dermatol Online J. 2017 Jan-Feb;8(1):16-24. doi: 10.4103/2229-5178.198765.
Secukinumab efficacy and safety in Indian patients with moderate-to-severe plaque psoriasis: sub-analysis from FIXTURE (Full Year Investigative Examination of Secukinumab vs. Etanercept Using Two Dosing Regimens to Determine Efficacy in Psoriasis), a randomized, placebo-controlled, phase 3 study.
Evidence has suggested Interleukin (IL)-17A to be an important effector cytokine in the pathogenesis of psoriasis. Here, we report results for an Indian sub-population from a multinational study FIXTURE, designed to assess the safety, tolerability, and long-term efficacy of fully human anti-IL-17A monoclonal antibody secukinumab in patients with moderate-to-severe plaque psoriasis.
In this double-dummy, placebo controlled, 52-weeks phase 3 study FIXTURE, 149 Indian patients were randomized 1:1:1:1 to receive secukinumab at a dose of 300 mg or 150 mg, etanercept, or placebo. The study objective was to show the superiority of secukinumab over placebo at week 12, vis-à-vis proportion of patients achieving a reduction of 75% or more from the baseline in the psoriasis area-and-severity index score (PASI 75) and a score of 0 (clear) or 1 (almost clear) on a 5-point modified investigator's global assessment (IGA mod 2011) (co-primary end points).
At week 12, 61.0% and 55.9% patients in secukinumab 300 mg and 150 mg groups, respectively, achieved PASI 75 response compared to 20.0% in the etanercept and 7.1% in the placebo groups. Similarly, IGA mod 2011 0 or 1 response was achieved by 43.9% and 20.6% in patients in the secukinumab 300 mg and 150 mg group, respectively, vs. 13.3% in the etanercept and 2.4% in the placebo groups at week 12. Likewise, higher proportions of patients in secukinumab 300 mg (41.5%) and 150 mg (20.6%) group were PASI 90 responders at week 12 than those in the etanercept (10.0%) or placebo (0.0%) groups. The incidences of adverse events (AEs), during the induction period were similar in all the treatment groups. Overall secukinumab was well-tolerated at both doses in the Indian sub-population.
The results from the Indian sub-population suggest that secukinumab is an efficacious and safe drug for use in moderate-to-severe chronic plaque psoriasis.
司库奇尤单抗治疗中重度斑块状银屑病印度患者的疗效和安全性:来自FIXTURE(使用两种给药方案对司库奇尤单抗与依那西普进行全年研究以确定银屑病疗效)的亚组分析,一项随机、安慰剂对照的3期研究
有证据表明白细胞介素(IL)-17A是银屑病发病机制中的一种重要效应细胞因子。在此,我们报告一项跨国研究FIXTURE中印度亚组的结果,该研究旨在评估全人源抗IL-17A单克隆抗体司库奇尤单抗治疗中重度斑块状银屑病患者的安全性、耐受性和长期疗效。
在这项双模拟、安慰剂对照、为期52周的3期研究FIXTURE中,149名印度患者按1:1:1:1随机分组,分别接受300mg或150mg剂量的司库奇尤单抗、依那西普或安慰剂。研究目的是在第12周时证明司库奇尤单抗相对于安慰剂的优越性,即达到银屑病面积和严重程度指数评分(PASI 75)较基线降低75%或更多以及在5分改良研究者整体评估(IGA mod 2011)中得分为0(清除)或1(几乎清除)的患者比例(共同主要终点)。
在第12周时,司库奇尤单抗300mg组和150mg组分别有61.0%和55.9%的患者达到PASI 75反应,相比之下依那西普组为20.0%,安慰剂组为7.1%。同样,在第12周时,司库奇尤单抗300mg组和150mg组分别有43.9%和20.6%的患者达到IGA mod 2011 0或1反应,而依那西普组为13.3%,安慰剂组为2.4%。同样,在第12周时,司库奇尤单抗300mg组(41.5%)和150mg组(20.6%)达到PASI 90反应的患者比例高于依那西普组(10.0%)或安慰剂组(0.0%)。在诱导期,所有治疗组的不良事件(AE)发生率相似。总体而言,在印度亚组中,两种剂量的司库奇尤单抗耐受性良好。
印度亚组的结果表明,司库奇尤单抗是一种用于治疗中重度慢性斑块状银屑病的有效且安全的药物。