INTRODUCTION: A mixed-treatment comparison (MTC) assessed the relative efficacy of secukinumab versus other biologics in patients with moderate-to-severe psoriasis.
METHODS: A systematic literature review was performed (MEDLINE, EMBASE, Cochrane Library) from inception to June 2013, including randomized control trials of Secukinumab (5), etanercept (7), adalimumab (6), infliximab (6) and Ustekinumab (7). Binomial MTCs were used to model PASI75 and PASI90. Bayesian random effects models are presented, fixed effects gave similar results. All analyses were conducted in R Development Core Team (2013). For placebo patients with no data at 16 weeks, 12-week data were carried forward. Results of PASI75 and PASI90 analyses at 12 and 16 weeks are presented.
RESULTS: Secukinumab 300 mg was the highest in the treatment hierarchy among all biologics. At 12 weeks, secukinumab was statistically superior to etanercept 50 mg and ustekinumab 45/90 mg and similar to adalimumab 80/40 mg and infliximab for PASI75. For PASI90, secukinumab was superior to etanercept 50 mg, ustekinumab 45 mg and adalimumab 80/40 mg and similar to ustekinumab 90 mg and infliximab. At 16 weeks, secukinumab was superior to etanercept 25/50 mg and ustekinumab 45/90 mg for PASI75. For PASI90, secukinumab was superior to adalimumab 80/40 mg, etanercept, and ustekinumab 45 mg.
CONCLUSIONS: Among psoriasis biologics in the network for PASI75 and PASI90, secukinumab 300 mg was the highest in the treatment hierarchy at 16 weeks. As measured by PASI response, secukinumab efficacy is superior at 12 and 16 weeks, relative to most other biologics, in treating moderate to severe psoriasis.
