Introduction & Objectives: Secukinumab is highly efficacious in the treatment of moderate to severe plaque psoriasis, with fast onset, a sustained effect, and a favorable safety profile. The objective of the current pooled analysis is to evaluate its impact on personal relationships and clothes worn as measured by the Dermatology Life Quality Index (DLQI).
Materials & Methods: Patients aged greater than or equal to 18 years were randomized 1:1:1 in ERASURE to subcutaneous treatment groups (secukinumab 300 mg, secukinumab 150 mg, & placebo) and 1:1:1:1 in FIXTURE (including an etanercept 50 mg twice-weekly group). The DLQI was administered at baseline, Weeks 4, 8, 12, 24, 36, and 52, with total, subscale, and item scores computed at all visits. This analysis used data for secukinumab 300 mg and etanercept from baseline to Week 52, placebo data up to Week 12, and focused on the personal relationship subscale (q8 & q9) and items assessing the influence on clothes worn (q4), impact on relationships with partners/close friends/relatives (q8), and sexual difficulties (q9). Treatment differences in mean scores were evaluated using van Elteren and proportions of DLQI subscale and item responders (score=0, indicating no impact) using Chi-square statistics.
Results: Subjects on secukinumab (n = 572) achieved greater mean improvement in the personal relationship subscale and q4, q8, and q9 than subjects on placebo (n = 572; all P less than 0.0001) and etanercept (n = 319; personal relationships: P less than 0.05 at Weeks 8 & 12; q4: all P less than 0.0001; q8: P less than 0.05 at Weeks 8 & 12; q9: all P less than 0.01). The response rates were higher for secukinumab 300 mg than for placebo (all P less than 0.0001; personal relationships Week 12 response rates: 48% vs. 16%; q4: 58% vs. 12%; q8: 45% vs. 16%; q9: 37% vs. 10%) and etanercept (personal relationships: all P less than 0.05 except for Weeks 4 & 36; q4: all P less than 0.05; q8: all P less than 0.05 except for Weeks 4 & 36; q9: numerically higher starting at Week 8; personal relationships Week 12 response rates: 48% vs. 38%, Week 52: 55% vs. 47%; q4 Week 12: 58% vs. 37%, Week 52: 66% vs. 47%; q8 Week 12: 45% vs. 37%, Week 52: 52% vs. 45%; q9 Week 12: 37% vs. 34%, Week 52: 40% vs. 36%).
Conclusions: Secukinumab 300 mg provides greater improvements and more effective relief from psoriasis impact on personal relationships and clothing worn than etanercept and placebo.
