Psoriasis Review: Studies Examine New Research in Psoriasis
Experts who presented at the 2018 Winter Clinical Dermatology–Hawaii reviewed long-term data for several psoriasis treatments and discussed recent and new drugs in development.
More than 400 dermatologists attended the 6-day program that provided the practicing dermatologist with a comprehensive update on the diagnosis and treatment of the wide range of conditions that face dermatologists daily. The conference is hosted by the Foundation for Research and Education in Dermatology.
Following are some highlights in therapeutic advances in the psoriasis area.
Ixekizumab Effective for Genital Psoriasis
Ixekizumab (Taltz) significantly improved the appearance of genital psoriasis compared with placebo, according to a poster by Ryan and colleagues.
The study included 149 patients with chronic plaque psoriasis and genital psoriasis. For 12 weeks, 75 participants received 80 mg of ixekizumab every 2 weeks and 74 participants received placebo. Using the static Physician’s Global Assessment (sPGA), the researchers measured the severity of genital psoriasis on a 6-point scale, with 0 indicating clear and 5 indicating very severe, at baseline and week 12. The main outcomes included the proportion of patients who achieved sPGA 0 or 1 for genital psoriasis, the proportion of patients who achieved overall sPGA of 0 or 1, the proportion of patients who achieved improvements in genital itch, and the proportion of patients who reported improved sexual activity.
At week 12, 7 of 10 patients who received ixekizumab achieved clear or almost clear genital skin and overall clear or almost clear skin. Ixekizumab was associated with significantly greater number of participants achieving clear or almost clear genital skin and overall clear or almost clear skin as early as week 1. The response to ixekizumab at week 12 was consistent across all patients, regardless of body surface area involvement at baseline.
In addition, 6 of 10 patients who received ixekizumab experienced clinically meaningful improvements in genital itch at week 12 and about 8 of 10 patients reported that their frequency of sexual activity was no longer limited or was rarely limited by genital psoriasis.
“Ixekizumab is an efficacious treatment for moderate to severe genital psoriasis, providing rapid clearance of genital skin,” according to the researchers.
Ryan C, Menter A, Guenther L, et al. Efficacy and safety of ixekizumab in a randomized, double-blinded, placebo-controlled, phase 3b clinical trial in patients with moderate-to-severe genital psoriasis. Presented at: The Winter Clinical Dermatology Conference; January 12-17, 2018; Maui, HI.
Biologic Yields Early and Sustained Skin Clearance for Patients With Plaque Psoriasis
A poster by Blauvelt and colleagues demonstrated that secukinumab (Cosentyx) quickly and effectively improved skin clearance in up to 65% of patients with moderate to severe plaque psoriasis.
For the study, the researchers conducted a post-hoc analysis of 4 clinical trials that included a total of 2396 patients with moderate to severe plaque psoriasis. Of the patients, 691 were randomly assigned to 300 mg of secukinumab, 692 were randomly assigned to 150 mg of secukinumab, 326 were randomly assigned to 50 mg etanercept (Enbrel), and 687 were randomly assigned to placebo. Responses were determined using the Investigator’s Global Assessment modified 2011 (IGA mod 2011) and Psoriasis Area and Severity Index (PASI) scores. The researchers evaluated the response rates of patients who achieved IGA mod 2011 0 (clear) or 0/1 (almost clear) over 1 year of treatment.
At the beginning of week 2, patients who received 2 doses of 300 mg of secukinumab showed significantly greater improvements compared with those who received placebo.
Compared with etanercept and placebo, significantly more patients who received either 150 mg or 300 mg of secukinumab achieved IGA mod 2011 0 and 0/1 responses at week 12. These responses were sustained at week 52, with significantly greater responses among patients who received 300 mg of secukinumab compared with those who received etanercept.
Among patients who achieved IGA 0/1 within 12 weeks, the median time to a 50% decrease in mean PASI scores from baseline was 2.6 weeks with 300 mg of secukinumab and 3.1 weeks with 150 mg of secukinumab. Among patients who achieved IGA 0 within 12 weeks, the median time to a 50% decrease in mean PASI scores from baseline were 2.3 weeks and 2.6 weeks for 300 mg of secukinumab and 150 mg of secukinumab, respectively.
In addition, IGA mod 2011 0 at week 52 was achieved by 37.8% of patients who received 300 mg of secukinumab, and PASI 100 at week 52 was achieved by 40.8% of patients who received 300 mg of secukinumab. Similarly, 0/1 was achieved by 64.9% of patients and PASI 90 was achieved by 68.1% of patients who received 300 mg of secukinumab at week 52.
“Secukinumab provides early and sustained skin clearance for patients with moderate to severe plaque psoriasis,” the researchers concluded.
Blauvelt A, Armstrong A, Rich P, et al. Secukinumab provides complete or almost-complete psoriasis clearance in moderate-to-severe plaque psoriasis: pooled analysis of 4 phase 3 trials. Presented at: The Winter Clinical Dermatology Conference; January 12-17, 2018; Maui, HI.
Article continues on page 2