Novel Antibody Obliterates Plaque Psoriasis

New studies show that treatment of longstanding plaque psoriasis with secukinumab, a fully human anti-interleukin-17A monoclonal antibody, was associated with rapid and dramatic improvements.

Researchers at Dalhousie University (Halifax, NS, Canada), Mount Sinai Hospital (New York, NY, USA), and other institutions conducted two phase 3, double-blind, 52-week trials to examine the efficacy of secukinumab over placebo with regard to the proportion of patients who had a reduction of 75% or more from baseline in the Psoriasis Area-and-Severity Index (PASI 75), and a score of 0 (clear) or 1 (almost clear) on a 5-point modified investigator's global assessment scale. Both studies had a 3-month induction phase, a 40-week maintenance period, and a further eight weeks of follow-up.

The first study, ERASURE, which enrolled 738 patients, showed PASI 75 score improvements in 81.6% of patients receiving 300 mg secukinumab at three months, and in 71.6% of those given 150 mg, compared with 4.5% of those randoizedm to placebo. In the second study, FIXTURE, which enrolled 1,306 patients, PASI 75 responses at 3 months were reported for 77.1% of the 300 mg secukinumab group, 67% of the 150 mg group, 44% of those receiving etanercept, and 4.9% of those given placebo. The study results were published on July 24, 2014, in the New England Journal of Medicine (NEJM).

“Secukinumab targets the proinflammatory cytokine interleukin 17A, which acts as a master cytokine in the pathogenesis of psoriasis,” concluded lead author Richard Langley, MD, of Dalhousie University, and colleagues. “Identifying that secukinumab blocks IL-17A is one of the most, if not the most, impressive results that we’ve seen to date in psoriasis research. Until now, we’ve not been able to identify the key players in the cause of this common skin condition.”

Psoriasis is a chronic skin condition with intermittent relapses characterized by patches, papules, and plaques, which usually itch. It is generally considered a genetic disease influenced by environmental factors, and affects approximately 1%–2% of the world’s population. Plaque psoriasis is the most common form, and typically manifests as red and white scaly patches. Skin cells rapidly accumulate at these plaque sites, creating silvery-white painful, itchy lesions. Psoriasis been linked to a host of health problems, including obesity arthritis, inflammatory bowel disease (IBD), hypertension, ischemic heart disease, and stroke.

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Dalhousie University
Mount Sinai Hospital