Efficacy and Safety of Secukinumab Over 52 Weeks in Chinese Psoriasis Patients With Concomitant Psoriatic Arthritis
For the millions of people living with psoriasis—a chronic inflammatory skin condition marked by red, scaly plaques—the added burden of psoriatic arthritis (PsA) can feel overwhelming. PsA, which causes joint pain, swelling, and stiffness, affects up to 30% of psoriasis patients worldwide. Now, new research offers hope for Chinese patients coping with both conditions: a 52-week study finds that the IL-17A inhibitor secukinumab delivers strong, sustained relief for both skin and joint symptoms, with a safety profile consistent with its known use.
The study, led by researchers from Peking University People’s Hospital, Zhejiang University’s Second Affiliated Hospital, and the General Hospital of Shenyang Military Region (with support from Novartis), focused on a subset of Chinese patients from the larger CAIN457A2318 Phase 3 trial. The original trial included 441 Chinese participants (81% of the total cohort) with moderate-to-severe psoriasis who had not responded to topical treatments, phototherapy, or systemic therapies. For this analysis, the team zeroed in on 24 patients who also had PsA (defined by ≥3 tender/swollen joints and meeting PsA classification criteria).
What the Study Did
Patients were randomized to one of three groups: secukinumab 300mg, secukinumab 150mg, or placebo. At week 12, placebo non-responders switched to secukinumab 300mg. The team tracked two key areas:
- Arthritis relief: Measured by the American College of Rheumatology (ACR) response, which quantifies improvements in joint pain, swelling, and function.
- Skin improvement: Assessed using the Psoriasis Area Severity Index (PASI, which scores plaque coverage and severity) and Investigator’s Global Assessment (IGA, a 0–4 scale for overall skin health).
- Quality of life: Evaluated with the Dermatology Life Quality Index (DLQI, for skin-related life impact) and Health Assessment Questionnaire-Disability Index (HAQ-DI, for arthritis-related disability).
Strong, Sustained Results for Joint and Skin Health
By week 12, secukinumab showed dramatic benefits for arthritis:
- 92% of patients on the 300mg dose achieved an ACR 20 response (a 20% reduction in arthritis symptoms)—a rate far higher than the 0% seen in the placebo group.
- 67% of patients on the 150mg dose also hit this milestone.
These gains held steady over the full year:
- 85% of the 300mg group maintained their ACR 20 response at week 52, while 50% of the 150mg group did the same.
- Even more impressive: 77% of the 300mg group achieved an ACR 50 response (50% improvement) by week 52, and 54% reached ACR 70 (70% improvement).
For skin symptoms, the results were equally promising:
- Nearly all secukinumab patients (93% on 300mg, 83% on 150mg) hit PASI 75 (a 75% reduction in psoriasis severity) by week 12—compared to 0% of placebo patients.
- These skin improvements stayed strong through week 52, with 93% of the 300mg group still at PASI 75.
- The higher 300mg dose also led to better “clear or almost clear” skin (IGA 0/1): 79% of patients achieved this by week 52, vs. 24% of the 150mg group.
Quality of Life Rebounded
Secukinumab also helped patients regain control of their daily lives:
- Over half (50%) of the 300mg group reported no impact on their quality of life (DLQI 0/1) by week 52, up from 21% at week 12.
- For arthritis-related disability (HAQ-DI), the 300mg group saw a 64% reduction in scores from baseline—meaning less difficulty with tasks like dressing, cooking, or walking. The 150mg group had a 41% reduction.
Safety Profile Consistent With Known Use
All patients in the study experienced at least one treatment-related adverse event (AE), but most were mild to moderate. The most common issues included:
- Gastrointestinal symptoms (42% of secukinumab patients).
- Non-serious infections (83% of secukinumab patients).
- Hypersensitivity reactions (33% of secukinumab patients, mostly mild eczema or urticaria).
Only one serious adverse event (hemorrhoids) was reported, and it was deemed unrelated to secukinumab. No new safety signals emerged—consistent with what’s known about the drug’s use in other populations.
While this study did not include radiographic (X-ray) evaluations, a prior Phase 3 trial (FUTURE 5) found that secukinumab reduces long-term joint damage in PsA patients over 52 weeks—adding confidence to its use for joint health.
What This Means for Chinese Patients
For Chinese patients with both psoriasis and PsA, the takeaway is clear: secukinumab works—and works consistently. The 300mg dose delivered superior results for both skin and joint symptoms, with sustained benefits over a full year. Quality of life improved dramatically, and safety remained predictable.
The study’s small size (24 patients) limits statistical comparisons between doses, but the trends are strong: higher doses of secukinumab offer better outcomes for patients with more severe disease. For a population where psoriasis severity is often higher than in Western countries—and where 14% of psoriasis patients have PsA (vs. 23% in Europe)—these findings fill a critical gap in treatment options.
The research was published in the Chinese Medical Journal in 2021 by Lin Cai (Peking University People’s Hospital), Jian-Zhong Zhang (Peking University People’s Hospital), Min Zheng (Zhejiang University), Shi-Fa Zhang (Shenyang Military Region General Hospital), and Manmath Patekar (Novartis).
doi.org/10.1097/CM9.0000000000001710
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