INTRODUCTION & OBJECTIVES: Secukinumab is highly efficacious in the treatment of moderate to severe plaque psoriasis, with early onset, a sustained effect, and a favorable safety profile. This pooled analysis focuses on evaluating the impact of secukinumab treatment versus etanercept on skin-related quality of life 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, and placebo) and 1:1:1:1 in FIXTURE (including an etanercept 50 mg twice-weekly group). The DLQI was administered at baseline and Weeks 4, 8, 12, 24, 36, and 52 with total, subscale, and item scores computed at all visits. This analysis used secukinumab 300 mg and etanercept data from baseline to Week 52. DLQI response was defined as no effect of skin problems on health-related quality-of-life (total score of 0 or 1, subscale of 0, and item score of 0). The effects of treatment on DLQI total scores, subscale scores (symptoms/feelings, daily activities, leisure, work/school, personal relationships, and treatment), and item scores were evaluated using the van Elteren and proportions of DLQI responders using Chi-square statistics.
RESULTS: Subjects treated with secukinumab 300 mg (n = 572) achieved greater mean improvement in DLQI total, 4 out of 6 subscales (all P less than 0.05; symptoms/feelings, daily activities, work/school [except at Week 24], and treatment), and 8 out of 10 item scores (all P less than 0.05; q1: itchy, sore, painful, stinging; q2: embarrassed; q3: shopping, home, garden; q4: clothing worn; q5: social or leisure activities; q7: work or studying (except at Week 24); q9: sexual difficulties; q10: treatment problems) than subjects treated with etanercept (n = 326) from Week 4 through Week 52. Secukinumab 300 mg achieved higher DLQI response rates for DLQI total and 5 subscales (except personal relationships) than etanercept starting at Week 4 through Week 52 (all P less than 0.05 except personal relationships). Item-level response rates were numerically higher for secukinumab 300 mg versus etanercept for all items (P less than 0.05 Week 8-52 for q1, q2, q3, q4, q5, q7, q10).
CONCLUSION: Overall, secukinumab provides greater improvements and relief from skin-related quality-of-life impact than etanercept in psoriasis.
