Study Results Demonstrate High Secukinumab Persistence in Psoriasis Patient Population of Greece

A recent study conducted in Greece provided significant insights into the long-term effectiveness and retention rates of secukinumab (Cosentyx; Novartis) in patients with moderate to severe plaque psoriasis.

The study, published in Dermatologic Therapy,¹ aimed to evaluate clinical outcomes, patient retention, and quality of life improvements over a 3-year period.

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Background and Methods

The SERENA study (CAIN457A3403) is a European longitudinal, observational study evaluating patients with moderate to severe plaque psoriasis who have received at least 16 weeks of secukinumab before enrollment.² This analysis focuses on patients enrolled in Greece, examining retention rates at 1, 2, and 3 years, as well as the effectiveness of secukinumab.

Findings

A total of 290 patients were included in the efficacy analysis. Prior to initiating secukinumab, nearly half of the patients had received previous treatments for psoriasis, including biologic agents (33.8%), conventional systemic treatments (19.7%), and phototherapy (5.5%). Among the biologics, ustekinumab was the most frequently used. Some patients had been treated with multiple biologics (13.8%).

Upon study enrollment, patients had been treated with secukinumab for an average of 1 year, with the majority receiving the biologic alone (93.1%). A small subset (6.8%) was treated with concomitant therapies, including topical or other systemic treatments.

Researchers reported that retention rates of secukinumab were notably high throughout the study period. At the end of the first year, 98.6% of patients remained on the treatment, while at the second and third years, the retention rates were 94.7% and 87.7%, respectively.

At the time of secukinumab initiation, the mean Psoriasis Area and Severity Index (PASI) score was 29.0, reflecting severe disease. By the time patients were enrolled in the study, this score had decreased to 4.0, and after 3 years of treatment, it further dropped to an average of 1.0.

At baseline, 92.7% of patients had a PASI score greater than 10, indicating severe disease, but after 1 year of treatment, over 86% of patients achieved a PASI score of 3 or lower, a marker of significant clinical improvement. By the third year, 84.6% of patients reached a PASI score of 2 or less, illustrating sustained efficacy.

By the third year, 97.5% of patients achieved a Physician Global Assessment score of 0 or 1, indicating clear or almost clear skin. This improvement in skin condition was further supported by the reduction in the proportion of patients with nail involvement and a body surface area greater than 10%.

At baseline, 59.5% of patients reported no impact on their quality of life based on the Dermatology Life Quality Index. This percentage increased annually, reaching 81.8% by the third year. Similarly, improvements were noted in the EQ-VAS (a general health-related quality of life measure), suggesting that secukinumab not only improved physical symptoms but also positively influenced patients' overall well-being.

Conclusions

"This interim analysis of real-world data from Greece showed high secukinumab retention rates as well as sustained effectiveness and QoL improvements over 3 years in patients with moderate to severe PsO," wrote study authors Ioannides et al. "Three-year interim results of SERENA also confirmed that secukinumab is well tolerated in the real clinical setting, while the overall incidence of treatment-emergent AEs was low."

The study may have been limited by selection bias. Researchers recommended further studies exploring retention and effectiveness parameters for secukinumab in patients with psoriasis.

References

1. Ioannides D, Rigopoulos D, Papakonstantis M, et al. Real-world experience of secukinumab treatment in patients with moderate-to-severe plaque psoriasis in Greece: 3-year interim results of the SERENA study. Dermatol Ther. September 18, 2024. https://doi.org/10.1155/2024/6530352
2. Health Research Authority. CAIN457A3403 (SERENA): secukinumab real life use in PSO, PSA and AS. HRA. Accessed September 24, 2024. https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/cain457a3403-serena-secukinumab-real-life-use-in-pso-psa-and-as/