Efficacy and Safety of Secukinumab in Elderly Patients with Moderate to Severe Plaque-Type Psoriasis: Post-Hoc Analysis of the SUPREME Study.

Purpose: Secukinumab is a fully human monoclonal antibody that inhibits interleukin (IL)-17A approved for the treatment of moderate to severe plaque psoriasis in adults and children. We compared the efficacy and safety of secukinumab in patients aged < 65 years (adult patients) versus patients aged ≥ 65 years (elderly patients) in a post-hoc analysis of the SUPREME study.
Patients and Methods: Patients with moderate to severe plaque psoriasis received subcutaneous secukinumab 300 mg per week for the first 5 weeks, then 300 mg per month. We compared the following outcomes in patients aged ≥ 65 years vs < 65 years: baseline characteristics; PASI50/75/90/100 response rates (improvements ≥ 50%/75%/90%/100% in Psoriasis Area and Severity Index (PASI) from baseline); changes in Dermatology Life Quality Index (DLQI); Hospital Anxiety and Depression Scale (HAD-A, HAD-D) score changes; treatment-emergent adverse events (TEAEs).
Results: Secukinumab was slightly less effective in elderly patients than in adult patients (response rates at week 16: PASI90, 69.4% vs 80.9%, p = 0.4528; PASI100, 44.4% vs 56.7%, p = 0.8973). Elderly and adult patients showed a similar time course of changes in absolute PASI scores. Patients aged ≥ 65 years had a statistically significantly lower improvement in quality of life (mean DLQI reduction) than patients aged < 65 years at week 16 [-5.4 (±4.3) vs -8.8 (±6.9), p = 0.0065] and at week 24 [-5.3 (±4.4) vs -9.2 (±7.1), p = 0.0038]. Secukinumab treatment resulted in comparable mean reductions in anxiety and depression scores in both cohorts at 24 weeks [HAD-A, -1.3 (±3.3) vs -2.1 (±3.8), p = 0.9004; HAD-D, -1.0 (±3.3) vs -1.5 (±3.1), p = 0.4598]. The frequency of TEAEs in the two cohorts was similar (16.7% vs 14.6%, p = 0.7391).
Conclusion: Secukinumab is a valid option for the management of moderate to severe psoriasis in elderly patients.
Competing Interests: M.T. has nothing to disclose; F.R. acted as speaker and consultant for Sanofi, AbbVie and Novartis, outside the submitted work; G.M. has nothing to disclose; K.H. reports personal fees from AbbVie, Almirall, Ganassini, LEO Pharma, Novartis, and Sanofi, outside the submitted work; M.P. has nothing to disclose; A.Ca. has nothing to disclose; A.P. has nothing to disclose; A.Ch. served as advisory board member and consultant and has received fees and speaker’s honoraria or has participated in clinical trials for AbbVie, Almirall, Incyte, LEO Pharma, Lilly, Janssen, Novartis, Pfizer, and Sanofi Genzyme; P.M. has nothing to disclose; F.B. has nothing to disclose; V.B. has nothing to disclose. P.D. has nothing to disclose; P.G. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for AbbVie, Almirall, Amgen, Janssen, LEO Pharma, Eli Lilly, Novartis, Pierre Fabre, Pfizer, Sandoz, Sanofi, UCB. C.Z. has nothing to disclose; C.P. has nothing to disclose; F.C. has nothing to disclose; MC.F. has served on advisory boards, received honoraria for lectures and research grants from Amgen, Almirall, AbbVie, BMS, Galderma, Kyowa Kirin, Leo Pharma, Pierre Fabre, UCB, Lilly, Pfizer, Janssen, MSD, Novartis, Sanofi-Regeneron, Sun Pharma.; S.T. acted as a speaker for AbbVie, Novartis and Janssen; P.B. has nothing to disclose; L.P. has nothing to disclose; G.G., M.B., L.C., and E.A. are employees of Novartis. AC received speaker’s/consultancy honoraria or grants for research from AbbVie, Almirall, Amgen, LEO Pharma, Novartis, Janssen, UCB, and Lilly. The authors report no other conflicts of interest in this work.
(© 2023 Talamonti et al.)