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Should Secukinumab Dosing for Psoriasis Be Adjusted for Patient Weight?

PASI 90 responses significantly higher for secukinumab 300 mg every two weeks versus every four weeks for patients weighing ≥90 kg

By Dermsquared Editorial Team | June 22, 2022

For patients with moderate-to-severe plaque psoriasis weighing ≥90 kg, secukinumab 300 mg every two weeks (Q2W) has improved and sustained efficacy compared with Q4W, according to a study published in the June issue of the British Journal of Dermatology.

Matthias Augustin, M.D., Ph.D., from the University Medical Center Hamburg-Eppendorf in Germany, and colleagues examined the efficacy, safety, and tolerability of secukinumab 300 mg Q2W versus Q4W in patients with moderate-to-severe chronic plaque psoriasis weighing ≥90 kg. A total of 331 patients were randomly assigned to receive Q2W (165 patients) or Q4W (166 patients).

At week 16, the researchers found significantly higher Psoriasis Area and Severity Index (PASI) 90 responses with Q2W versus Q4W (73.2 versus 55.5 percent; odds ratio estimate, 2.3). Higher efficacy responses were maintained in the Q2W arm at week 52 (versus Q4W) for PASI 75 (88.9 versus 74.8 percent), PASI 90 (76.4 versus 52.4 percent), PASI 100 (46.7 versus 27.3 percent), Investigator's Global Assessment 0/1 (75.9 versus 55.6 percent), and Dermatology Life Quality Index 0/1 (66.1 versus 48.8 percent). Higher efficacy responses were seen at week 32 for PASI 90 nonresponders at week 16 who uptitrated to Q2W versus those who remained on Q4W (16 weeks post-uptitration, PASI 90: 38.7 versus 16.5 percent). Comparable safety results were seen across treatment arms.

"These results further support the use of an alternative treatment regimen for heavier patients with psoriasis (weighing ≥90 kg) with the aim of rapidly controlling their disease and achieving PASI 90 responses," the authors write.

Several authors disclosed financial ties to biopharmaceutical companies, including Novartis, which manufactures secukinumab and funded the study.

Abstract/Full Text


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