Patients With Psoriasis, Higher Body Weight Benefit From Treatment Every 2 Weeks

Secukinumab 300 mg dosed every 2 weeks demonstrated superior and sustained efficacy compared with every 4 weeks in patients with moderate-to-severe plaque psoriasis weighing 90 kilograms or more, with side effects consistent with secukinumab’s established safety profile. Researchers published their findings in the British Journal of Dermatology.

“Overall, the option of more frequent dosing of secukinumab in patients who are heavier should help ensure patients receive treatment that is tailored to them and help meet their treatment goals,” wrote a research team from the United States and Europe.

The multicenter, double-blind study randomized 331 patients with moderate-to-severe chronic plaque psoriasis to receive secukinumab 300 mg every 2 weeks (Q2W) or every 4 weeks (Q4W). All participants weighed 90 kilograms or more.

At week 16, 73.2% of participants who received Q2W dosing achieved Psoriasis Area and Severity Index (PASI) 90 response compared with 55.5% of participants who received Q4W dosing, according to study authors.

At week 52, higher efficacy with the Q2W regimen persisted: PASI 75 response was achieved by 88.9% of participants with Q2W compared with 74.8% of participants with Q4W dosing; PASI 90 response, by 76.4% compared with 52.4%; PASI 100 response, by 46.7% compared with 27.3%; Investigator’s Global Assessment 0/1, by 75.9% compared with 55.6%; and Dermatology Life Quality Index 0/1, by 66.1% compared with 48.8%.

The study also reallocated patients originally assigned the Q4W regimen who did not achieve PASI 90 at week 16 to either remain on Q4W or to uptitrate to Q2W. By week 32, PASI 90 was achieved by 38.7% of patients who switched to Q2W compared with 16.5% who stayed with Q4W dosing, showed study findings.

“This analysis confirmed that the safety profile in both dosing regimens was similar and consistent with that previously established,” reported researchers, “with no trend towards increased incidence of adverse events evident with the secukinumab 300 mg Q2W regimen despite a higher exposure.”

Reference:
Augustin M, Reich K, Yamauchi P, et al. Secukinumab dosing every 2 weeks demonstrated superior efficacy compared with dosing every 4 weeks in patients with psoriasis weighing 90 kg or more: results of a randomized controlled trial. Br J Dermatol. 2022;186(6):942-954. doi:10.1111/bjd.20971