Drug survival of secukinumab for psoriasis in a real-world setting

Secukinumab, an IL-17 inhibitor, is effective for psoriasis and psoriatic arthritis but may have lower drug survival than other biologics in clinical practice (1,2). We retrospectively examined drug survival in 48 patients treated with secukinumab for psoriasis at Kaiser Permanente Los Angeles Medical Center dermatology clinic from January 21, 2015 to January 19, 2018 (Table 1), 12 of whom also had psoriatic arthritis (PsA). Secukinumab failure was defined as adding an oral medication or phototherapy or switching to a different oral or biologic agent. Failure date was set as the date at which the therapy was changed. Kaplan-Meier methodology was used to calculate drug survival probability in the cohort (persistence groups were censored) and provide a comprehensive survival duration. Twenty of 48 (41.7%) of patients persisted on secukinumab therapy throughout the study period (range 74 to 1004, Table 1), eighteen of whom were biologic-experienced. The remaining patients failed therapy after an average of 291 days and median of 198 days of treatment; all but one were biologic-experienced. Of patients with concurrent PsA, 10 of the 12 failed therapy after an average of 316 days. Mean and median drug survival durations (Figure 1) were 512 days (95% confidence interval 216–436 days) and 198 days, respectively.