Efficacy of secukinumab without the initial weekly loading dose in patients with chronic plaque psoriasis.

BACKGROUND: Secukinumab is administered at the labelled dose of 300 mg at weeks 0, 1, 2, 3, 4 (loading dose) and every 4 weeks thereafter.

OBJECTIVE: To investigate the efficacy of secukinumab administered without the initial loading dose in patients with psoriasis.

MATERIALS AND METHODS: a retrospective, observational study including adult patients with psoriasis (n=156) treated with secukinumab 300 mg administered either according to the labelled dose (n=75) or without the initial loading dose (n=81). Efficacy was evaluated by comparing the PASI 75 and PASI 90 response rates at week 8, 12, 16, 32 and 48.

RESULTS: PASI 75 response rates were achieved at week 8, 12, 16, 32 and 48 by 60.01% and 40.20% (p<0.01), 72.22% and 60.61% (p<0.01), 77.35 and 74.68%, 85.14% and 77.19%, 78.57% and 77.59% of those who received the labelled dose versus those who did not, respectively. PASI 90 response were achieved at the same time points by 45.10% and 30.50% (p<0.01), 49.37% and 40.30% (p<0.01), 54.44% and 46.67%, 54.65% and 47.37%, 56.9% and 54.29% of those who received the labelled dose versus those who did not, respectively. A greater proportion of patients receiving secukinumab without the loading dose discontinued it because of inefficacy (24.6% vs 13.3%, p<0.05), particularly those with body weight greater than 80 kg.

CONCLUSIONS: Secukinumab administered without the loading dose is associated with a higher proportion of primary inefficacy, and it is inferior compared to the labelled dose at week 8 and 12, but with similar efficacy thereafter. ClinicalTrials gov identification number NCT03828643. This article is protected by copyright. All rights reserved.