Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France.
Clin Exp Dermatol. 2019 Oct;44(7):e230-e234. doi: 10.1111/ced.13999. Epub 2019 May 22.
There are limited data regarding the long-term continuation with biological therapy for patients with psoriasis. In particular, the reasons for secukinumab discontinuation have not been thoroughly investigated.
To better ascertain the real-life continuation of secukinumab in psoriasis, we conducted a retrospective study to evaluate the incidence, causes and factors of secukinumab discontinuation in patients with psoriasis.
All patients treated with secukinumab for psoriasis in the Department of Dermatology (Toulouse University and Larrey Hospital, Toulouse, France), between September 2011 and June 2017, were enrolled in the study.
Of the 91 patients in the study, 22 (24.2%) discontinued secukinumab. In 14 (15%) patients, the discontinuation was due to loss of efficacy. Two patients stopped treatment because they planned a pregnancy and five patients stopped because of adverse events. A longer disease duration (P = 0.01) and presence of palmoplantar psoriasis (P = 0.01) seem to be predictive factors for treatment failure. Patients reaching 90 or 100% improvement in Psoriasis Area and Severity Index (PASI90 and PASI100, respectively) at weeks 12-16 had a lower risk of long-term treatment discontinuation compared with patients who had less complete clearance (P = 0.04).
Long-term persistence of secukinumab appears to be good, as only 24.2% (n = 22) of the patients in this study discontinued secukinumab over the follow-up period. Loss of efficacy prompted discontinuation in about 14% of patients by the 2-year follow-up. Persistence appears to be lower in patients with palmoplantar psoriasis and in patients previously exposed to many systemic treatments. Optimal therapeutic response at 12-16 weeks as defined by reaching PASI90-100 seems to be predictive of long-term treatment persistence.
关于银屑病患者长期接受生物治疗的持续情况，数据有限。特别是，关于司库奇尤单抗停药的原因尚未得到彻底调查。
为了更好地确定司库奇尤单抗在银屑病中的实际应用情况，我们进行了一项回顾性研究，以评估银屑病患者使用司库奇尤单抗的停药发生率、原因和影响因素。
研究纳入了 2011 年 9 月至 2017 年 6 月期间在法国图卢兹大学和拉雷医院皮肤科接受司库奇尤单抗治疗的所有银屑病患者。
在 91 例患者中，有 22 例（24.2%）停止使用司库奇尤单抗。其中 14 例（15%）是因为疗效丧失，2 例是因为计划怀孕，5 例是因为不良事件。较长的疾病病程（P=0.01）和手掌足底银屑病的存在（P=0.01）似乎是治疗失败的预测因素。在第 12-16 周达到银屑病面积和严重程度指数（PASI）90%或 100%改善（PASI90 和 PASI100）的患者与未完全清除的患者相比，长期停药的风险较低（P=0.04）。
司库奇尤单抗的长期持续应用似乎较好，在这项研究中，只有 24.2%（n=22）的患者在随访期间停止使用司库奇尤单抗。在 2 年随访时，约 14%的患者因疗效丧失而停药。手掌足底银屑病和既往接受过多系统治疗的患者的持续性较低。在第 12-16 周达到 PASI90-100 的最佳治疗反应似乎可以预测长期治疗的持续性。
