High Drug Survival in Biologic-Naïve Psoriasis Patients Treated with Secukinumab

Peter Foley, MD

New 21-month data from the SUSTAIN study found that the biologic secukinumab demonstrated high drug survival and sustained efficacy in both biologic-naïve and biologic-experienced patients with chronic plaque psoriasis.

Previous research had shown secukinumab to be highly effective in treating variations of psoriatic disease, and the drug was previously approved in Australia for moderate to severe CPP on January 12, 2015.

For the SUSTAIN study, an investigative team led by Peter Foley, MD, FACD, of the Skin Health Institute in Victoria, Australia, sought to establish the drug survival rate and effectiveness of the drug in patients with severe CPP in a routine clinical setting.

Study Design

The SUSTAIN study utilized secondary data from an online database called the Australian Psoriasis Registry (APR), specifically data related to patients 18 years and older who had inititated secukinumab 300 mg for severe CPP between January 12, 2015, and December 31, 2019.

After data were collected, the study population was stratified into patients with and without prior biologic exposure, with the former group being subcategorized based on the number of agents used.

At baseline and at months 3, 6, 9, 15, and 21, patients were analyzed for PASI and DLQI, though not all patients had a PASI assessment. Investigators utilized Kaplan-Meier survival curves to evaluate drug survival.

The Findings

Among the 301 patients whose data were included in the study,294 were included in the Full Analysis Set, as 7 patients in the original group had received the first dose of secukinumab before January 12, 2015.

Less than half (n=110, 37.4%) of all patients were biologic-naïve, while 184 (62.6%) patients had experience with biologic therapy. Specifically, 94 (32%) had previous exposure to 1 biologic therapy, while 42 (14.3%) and 48 (16.3%) patients had previous exposure to 2 and 3 or more therapies, respectively.

At 9 months, investigators found that drug survival rates were 0.92 and 0.86 for biologic-naïve and experienced patients with CPP, respectively, according to Kaplan-Meier survival curves. Similar scores were recording at 21 months, with survival rates being 0.82 and 0.68, respectively.

Notably, PASI 75/90/100 responses for biologic-naïve compared to biologic-experienced patients were 100/87.7/38.4 and 98.5/61.5/27.2 at 9 months, respectively. At 21 months, responses were 100/81.0/41.7 for the naïve group compared to 98.4/62.0/24.2 for the experienced group.

A total of 70 adverse events were reported by 54 (18.4%) patients, with the most common events requiring systemic antibiotics (5.4%).

“Biologic-naïve patients undergoing secukinumab treatment had better drug survival and effectiveness than with biologic-experienced patients,” the team wrote. “No new safety signals were observed in the APR, and the safety profile of secukinumab was in line with its label.”

The study, "Secukinumab treatment demonstrated high drug survival and sustained effectiveness in patients with severe chronic plaque psoriasis: 21-month analysis in Australian routine clinical practice (SUSTAIN study)," was published online in the Australian Journal of Dermatology.