Mastorino Luca, Dapavo Paolo, Cariti Caterina, Susca Sara, Siliquini Niccolò, Ortoncelli Michela, Stroppiana Elena, Verrone Anna, Giunipero di Corteranzo Isotta, Leo Francesco, Quaglino Pietro, Ribero Simone
Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy.
J Pers Med. 2024 Jul 3;14(7):718. doi: 10.3390/jpm14070718.
the selective IL-17 inhibitor secukinumab has demonstrated efficacy and safety in the treatment of moderate-severe psoriasis in recent years.
evaluate effectiveness and drug survival (DS) of secukinumab in patients with psoriasis for up to 5 years.
This is a retrospective study on a monocentric cohort of patients with psoriasis on secukinumab evaluating the achievement of PASI100, PASI90, and PASI ≤ 3 and DS analysis up to 260 weeks. DS multivariate analysis was carried out considering sex, age, age of onset of the disease, obesity, cardiovascular comorbidities, diabetes, involvement of difficult-to-treat sites, psoriatic arthritis, treatment-naïve status, and mean baseline PASI.
At baseline, we evaluated 255 patients on secukinumab. PASI100 was reached by 41.7% and 70.6% of patients at weeks 16 and 260, respectively. PASI90 showed a similar trend with 46.5% of patients achieving it at week 16 and 88.2% at week 260. Non-obese patients showed a faster response than patients with obesity in achieving PASI100, PASI90, and PASI ≤ 3, with significant differences at 28 weeks [55% vs. 40% ( = 0.033), 64% vs. 49% ( = 0.038), and 76% vs. 62% ( = 0.036), respectively]. The estimated DS for secukinumab was 84.3% at 12 and 48% at 60 months. Obesity and smoking habits were associated with a higher risk of discontinuation in multivariate models (HR 1.6 CI 1.05-2.45, = 0.028; HR 1.48 CI 1.01-2.17, = 0.043, respectively).
Secukinumab showed effectiveness for up to 5 years of treatment, with a high DS and achievement of PASI100, PASI90, and PASI < 3 at these time points. Only obesity reduced the response and maintenance of DS.
近年来，选择性白细胞介素-17抑制剂司库奇尤单抗已在中度至重度银屑病的治疗中展现出疗效和安全性。
评估司库奇尤单抗在银屑病患者中长达5年的有效性和药物留存率（DS）。
这是一项对单中心队列中接受司库奇尤单抗治疗的银屑病患者的回顾性研究，评估达到PASI100、PASI90和PASI≤3的情况以及长达260周的DS分析。进行DS多变量分析时考虑了性别、年龄、疾病发病年龄、肥胖、心血管合并症、糖尿病、难治疗部位受累情况、银屑病关节炎、未接受过治疗的状态以及平均基线PASI。
在基线时，我们评估了255例接受司库奇尤单抗治疗的患者。分别有41.7%和70.6%的患者在第16周和第260周达到PASI100。PASI90呈现类似趋势，在第16周有46.5%的患者达到，在第260周有88.2%的患者达到。非肥胖患者在达到PASI100、PASI90和PASI≤3方面比肥胖患者反应更快，在第28周时有显著差异[分别为55%对40%（P = 0.033）、64%对49%（P =0.038）以及76%对62%（P = 0.036）]。司库奇尤单抗在12个月时的估计DS为84.3%，在60个月时为48%。在多变量模型中，肥胖和吸烟习惯与停药风险较高相关（风险比分别为1.6，置信区间1.05 - 2.45，P = 0.028；风险比1.48，置信区间1.01 - 2.17，P = 0.043）。
司库奇尤单抗在长达5年的治疗中显示出有效性，在这些时间点具有较高的DS以及达到PASI100、PASI90和PASI<3。只有肥胖降低了反应和DS的维持。
