Introduction & Objectives: Secukinumab is highly efficacious in the treatment of moderate to severe plaque psoriasis, starting at early time points, with a sustained effect and a favorable safety profile. This pooled analysis focuses on evaluating the impact of secukinumab treatment versus placebo 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 placebo data from baseline to Week 12. 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 treatment effects on DLQI total scores, subscale scores (symptoms/feelings, daily activities, leisure, work/school, personal relationships, and treatment), and item scores were evaluated. Proportions of DLQI responders were also compared.
Results: Subjects treated with secukinumab 300 mg (n = 572) achieved greater mean improvement in DLQI total, subscale, and item scores than subjects treated with placebo (n = 572) from Week 4 through Week 12 (all P less than 0.001). Secukinumab 300 mg achieved higher DLQI response rates for total, subscales, and items than placebo at all visits through Week 12 (all P less than 0.001; Week 12 DLQI 0/1: 58% vs. 8%; symptoms/feelings: 48% vs. 4%; daily activities: 59% vs. 12%; leisure: 56% vs. 17%; work/school: 52% vs. 21%; personal relationships: 48% vs. 16%; treatment: 53% vs. 18%; q1–itchy, sore, painful, stinging: 56% vs. 5%; q2–embarrassed: 58% vs. 10%; q3–shopping, home, garden: 54% vs. 21%; q4–clothing worn: 58% vs. 12%; q5–social or leisure activities: 57% vs. 18%; q6–sports: 43% vs. 17%; q7–work or studying: 52% vs. 21%; q8–partner/friend/relative: 45% vs. 16%; q9–sexual difficulties: 37% vs. 10%; q10–treatment problems: 53% vs. 18%).
Conclusions: Secukinumab provides greater improvements and relief from skin-related quality-of-life impact than placebo in moderate to severe psoriasis.
