Secukinumab treatment results in sustained drug survival in biologic-naive and biologic-experienced patients with moderate-to-severe plaque psoriasis: analysis of 24 months of follow-up data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)

ABSTRACT

Secukinumab is a fully human anti-interleukin-17A monoclonal antibody for the treatment of moderate-to-severe plaque psoriasis. In a previous analysis of the ongoing, longitudinal pharmacovigilance register BADBIR (data cutoff 31 August 2020), secukinumab showed sustained drug survival over 24 months in biologic-naive patients (86%) comparable to that of biologic-naive patients treated with ustekinumab (84%) and greater than that of biologic-naive patients treated with adalimumab (71%). In this updated analysis, we report drug survival for a larger cohort of biologic-naive and biologic-experienced patients with psoriasis treated with secukinumab (- data cutoff 31 August 2021). Patients prescribed secukinumab at baseline (biologic-naive) or after switching therapies during follow-up (biologic-experienced) were included. Drug survival up to 24 months (Kaplan-Meier method) was defined as the duration between date of first secukinumab exposure and date of stopping secukinumab or the end of the study censoring period. Data from 2850 patients were analysed (949 biologicnaive;1901 biologic-experienced). Mean duration of followup was 2.9 years (median 2.9 years) for biologic-naive and 2.7 years (median 2.5 years) for biologic-experienced patients. Among biologic-naive and biologic-experienced patients, respectively, most were male (61.3% and 55.6%), mean age was 46.5 and 45.1 years, mean body mass index was 31.6 and 32.5 kg m-2, mean age of disease onset was 25.6 and 23.7 years, and mean disease duration was 20.9 and 21.4 years. For biologic-experienced patients, the mean (SD) number of prior biologics received was 1.8 (1.0). Fewer biologicnaive patients had psoriatic arthritis (21.2% vs. 33.2%) and had received prior ciclosporin (50.1% vs. 60.1%), and prior methotrexate use was similar between subgroups (74.3% vs. 76.8%). Overall drug survival for biologic-naive and biologicexperienced patients was comparably high after 12 months (89% vs. 78%) and 24 months (78% vs. 62%). Drug survival for biologic-experienced patients was similar to that previously reported [77% (12 months) and 59% (24 months)]. With a median follow-up of 2.9 and 2.5 years for biologic-naive and biologic-experienced patients, respectively, these data represent the longest follow-up of any BADBIR analysis to date supporting and extending previous findings of sustained drug survival of secukinumab in patients with moderate-to-severe plaque psoriasis in real-world practice. As expected, drug survival was higher in patients who initiated secukinumab at baseline than those who switched to secukinumab after other biological therapy. However, overall drug survival of 78% and 62% at 12 and 24 months in biologic-experienced patients was similar to that reported previously [77% (12 months) and 59% (24 months)], and just slightly lower than was reported before the COVID-19 pandemic [81% (12 months) and 63% (24 months)].