Effectiveness of secukinumab in patients with psoriasis and psoriatic arthritis in a Saudi real-world setting

Al-Homood, Ibrahim A.; Alajlan, Mohammed; Alberdisi, Majid; Alturki, Mohammad; Ahmed, Ahmed Ali; Zakaria, Nancy

doi:10.1186/s42358-024-00371-1

Ibrahim A. Al-Homood ^**Correspondence: Ibrahim A. Al-Homood iaalhomood@kfmc.med.sa

conceptualized the project and provided supervision

supervised data collection and provided regular feedback

provided constructive feedback

revised the first draft of the manuscript

critically read, revised and approved the final manuscript

Internal Medicine Department, Medical Specialities Department, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0000-0001-6391-6938

Mohammed Alajlan

conceptualized the project and provided supervision jointly

supervised data collection and provided regular feedback

provided constructive feedback along

revised the first draft of the manuscript

critically read, revised and approved the final manuscript

Dermatology Department, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0009-0007-5497-0458

Majid Alberdisi

conceptualized the project and provided supervision jointly

supervised data collection and provided regular feedback

provided constructive feedback along

revised the first draft of the manuscript

critically read, revised and approved the final manuscript

Internal Medicine Department, Medical Specialities Department, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0000-0001-8149-8944

Mohammad Alturki

conceptualized the project and provided supervision jointly

supervised data collection and provided regular feedback

provided constructive feedback along

revised the first draft of the manuscript

critically read, revised and approved the final manuscript

Immunology Medical Affairs, Novartis, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0009-0004-5072-3722

Ahmed Ali Ahmed

provided constructive feedback along

critically read, revised and approved the final manuscript

Immunology Medical Affairs, Novartis, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0000-0003-4319-8232

Nancy Zakaria

provided constructive feedback along

critically read, revised and approved the final manuscript

Immunology Medical Affairs, Novartis, Riyadh, Kingdom of Saudi Arabia

https://orcid.org/0009-0008-9378-740X

*Correspondence: Ibrahim A. Al-Homood iaalhomood@kfmc.med.sa

Competing interests

NZ, AA and MA are employees of the company Novartis Pharmaceuticals. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. IA is an employee of KFMC, has received grant/ research support from Novartis, GSK and Pfizer and speaker honoraria from Pfizer, AbbVie, GSK, Novartis, Eli Lilly.

Dr. Nouran Hamza completed the statistical analysis, wrote the first draft of the manuscript and made required revisions.

Baseline patients' characteristics		Psoriasis (PsO) N = 25 (30.9%)	Psoriatic arthritis (PsA) N = 7 (8.6%)	PsO-PsA N = 49 (60.5%)	Total N = 81 (100%)
Demographics
Age (years)	Mean (SD)	36.7 (12.9)	41.3 (10.5)	42.7 (13.9)	40.7 (13.5)
Age of diagnosis (years)	Mean (SD)	25.3 (12.4)	30.9 (12.3)	31.8 (14.0)	29.7 (13.5)
Age at starting Secukinumab (years)	Mean (SD)	34.4 (13.2)	39.9 (10.4)	41.3 (13.7)	39.0 (13.6)
Disease duration (years)	Median (IQR)	11.0 (7.0 to 16.0)	4.0 (3.0 to 10.5)	10.0 (6.0 to 13.0)	10.0 (6.0 to 14.0)
Gender	Male	13 (52.0)	3 (42.9)	20 (40.8)	36 (44.4)
Source clinics	Dermatology	25 (100.0)	1 (14.3)	31 (63.3)	57 (70.4)
	Rheumatology	0 (0.0)	6 (85.7)	18 (36.7)	24 (29.6)
Clinical & comorbidities
Diabetes Mellitus		3 (12.0)	1 (14.3)	13 (26.5)	17 (21.0)
Hypertension		2 (8.0)	1 (14.3)	11 (22.4)	14 (17.3)
Ischemic Heart Disease (IHD)		1 (4.0)	0 (0.0)	5 (10.2)	6 (7.4)
Lung diseases		0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
Renal disease		0 (0.0)	0 (0.0)	3 (6.1)	3 (3.7)
Depression		7 (28.0)	1 (16.7)	8 (16.3)	16 (20.0)
Uveitis		1 (4.0)	1 (14.3)	0 (0.0)	2 (2.5)
Neurological disease		0 (0.0)	0 (0.0)	2 (4.1)	2 (2.5)
Treatment variables
Previous exposure to biologics		13 (52.0)	3 (42.9)	38 (77.6)	54 (66.7)
Rituximab (RTX)	No	24 (96.0)	7 (100.0)	48 (98.0)	79 (97.5)
	Stopped	1 (4.0)	0 (0.0)	0 (0.0)	1 (1.2)
	Yes	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
Infliximab	Currently	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
	No	25 (100.0)	7 (100.0)	45 (91.8)	77 (95.1)
	Stopped	0 (0.0)	0 (0.0)	3 (6.1)	3 (3.7)
Etanercept	No	22 (88.0)	5 (71.4)	29 (59.2)	56 (69.1)
	Stopped	3 (12.0)	2 (28.6)	20 (40.8)	25 (30.9)
Adalimumab	No	14 (56.0)	5 (71.4)	29 (59.2)	48 (59.3)
	Stopped	11 (44.0)	2 (28.6)	19 (38.8)	32 (39.5)
	Yes	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
Certolizumab Pegol	Currently	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
	No	25 (100.0)	6 (85.7)	46 (93.9)	77 (95.1)
	Stopped	0 (0.0)	1 (14.3)	2 (4.1)	3 (3.7)
Tofacitinib	Currently	0 (0.0)	0 (0.0)	2 (4.1)	2 (2.5)
	No	25 (100.0)	7 (100.0)	45 (91.8)	77 (95.1)
	Stopped	0 (0.0)	0 (0.0)	2 (4.1)	2 (2.5)
Upadacitinib	Currently	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
	No	25 (100.0)	7 (100.0)	48 (98.0)	80 (98.8)
Guselkumab	Currently	4 (16.0)	2 (28.6)	6 (12.2)	12 (14.8)
	No	20 (80.0)	5 (71.4)	41 (83.7)	66 (81.5)
	Stopped	1 (4.0)	0 (0.0)	2 (4.1)	3 (3.7)
Secukinumab	Currently	19 (76.0)	6 (85.7)	37 (75.5)	62 (76.5)
	Stopped	6 (24.0)	1 (14.3)	12 (24.5)	19 (23.5)
Ustekinumab	Currently	1 (4.0)	0 (0.0)	0 (0.0)	1 (1.2)
	No	20 (80.0)	7 (100.0)	42 (85.7)	69 (85.2)
	Stopped	4 (16.0)	0 (0.0)	7 (14.3)	11 (13.6)
Methotrexate	No	15 (62.5)	2 (28.6)	22 (44.9)	39 (48.8)
	Stopped	7 (29.2)	3 (42.9)	18 (36.7)	28 (35.0)
	Yes	2 (8.3)	2 (28.6)	9 (18.4)	13 (16.2)
Disease severity measures (Baseline)
Disease activity at enrollment	Active	13 (52.0)	2 (28.6)	27 (55.1)	42 (51.9)
	Mild	12 (48.0)	5 (71.4)	22 (44.9)	39 (48.1)
Peripheral involvement		0 (0.0)	7 (100.0)	48 (98.0)	55 (96.5)
Axial involvement		0 (0.0)	2 (28.6)	15 (32.6)	17 (31.5)
Swollen Joint Count (SJC)	Median (IQR)	0.0 (0.0 to 0.0)	6.0 (5.0 to 6.5)	6.0 (4.0 to 7.0)	4.0 (0.0 to 7.0)
Total Joint Count (TJC)	Median (IQR)	0.0 (0.0 to 0.0)	9.0 (7.0 to 10.5)	7.0 (5.0 to 9.0)	5.0 (0.0 to 8.0)
Disease Activity in Psoriatic Arthritis score (DAPSA)	Median (IQR)	0.0 (0.0 to 0.0)	29.2 (26.8 to 32.8)	28.1 (25.0 to 33.2)	25.1 (0.0 to 30.2)
Psoriasis Area Severity Index (PASI)	Median (IQR)	18.0 (12.0 to 20.0)	0.0 (0.0 to 0.0)	9.0 (7.0 to 14.0)	11.0 (8.0 to 18.0)
Body Surface Area (%)	Median (IQR)	30.0 (20.0 to 44.0)	0.0 (0.0 to 0.0)	15.0 (8.0 to 30.0)	20.0 (8.0 to 35.0)
Dermatology Quality of Life Index (DLQI)	Mean (SD)	15.4 (4.3)	1.0 (2.4)	10.8 (5.3)	11.5 (6.1)
Human Leukocyte Antigen-B27	Positive	0 (0.0)	0 (0.0)	1 (2.0)	1 (1.2)
	Negative	2 (8.0)	2 (28.6)	6 (12.2)	10 (12.3)
Erythrocyte Sedimentation Rate (ESR)	Median (IQR)	23.0 (16.2 to 52.2)	29.0 (13.0 to 43.0)	36.0 (23.0 to 55.8)	35.5 (22.8 to 53.2)
C-reactive protein (CRP)	Median (IQR)	3.7 (2.3 to 6.6)	1.9 (0.4 to 2.4)	4.1 (1.8 to 7.3)	3.7 (1.8 to 6.7)
Treatment discontinuation
Inflammatory bowel disease secondary to Secukinumab		0 (0.0)	0 (0.0)	2 (4.1)	2 (2.5)
Secukinumab duration (months)	Median (IQR)	21.0 (10.0 to 35.0)	24.0 (10.0 to 25.5)	16.0 (8.0 to 27.0)	18.0 (9.0 to 28.0)
Reason of discontinuation	Non-stop	19 (82.6)	6 (85.7)	37 (77.1)	62 (76.5)
	Active disease	1 (4.3)	0 (0.0)	8 (16.7)	9 (47.4)^a a Estimated among those stopped Secukinumab (23.5%)
	No improvement	2 (8.7)	1 (14.3)	1 (2.1)	4 (21.1)^a a Estimated among those stopped Secukinumab (23.5%)
	Patient controlled	1 (4.3)	0 (0.0)	2 (4.2)	3 (15.8)^a a Estimated among those stopped Secukinumab (23.5%)
3 months follow-up (%)	Median (IQR)	50.0 (40.0 to 60.0)	50.0 (25.0 to 70.0)	60.0 (40.0 to 80.0)	60.0 (40.0 to 70.0)
6 months follow-up (%)	Median (IQR)	70.0 (60.0 to 80.0)	70.0 (60.0 to 87.5)	80.0 (70.0 to 90.0)	80.0 (60.0 to 90.0)
12 months follow-up (%)	Median (IQR)	80.0 (60.0 to 90.0)	75.0 (67.5 to 82.5)	90.0 (80.0 to 100.0)	85.0 (60.0 to 92.5)
18 months follow-up (%)	Median (IQR)	90.0 (75.0 to 100.0)	90.0 (87.5 to 92.5)	90.0 (80.0 to 100.0)	90.0 (80.0 to 100.0)

[1] *Correspondence: Ibrahim A. Al-Homood iaalhomood@kfmc.med.sa

Brasil

Brasil

Effectiveness of secukinumab in patients with psoriasis and psoriatic arthritis in a Saudi real-world setting

Abstract

Introduction

Methods

Results

Conclusion