부산대학교 도서관

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 [greater than or equal to] 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 [greater than or equal to] 65 years vs < 65 years: baseline characteristics; PASI50/75/90/100 response rates (improvements [greater than or equal to] 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 [greater than or equal to] 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 ([+ or -]4.3) vs -8.8 ([+ or -]6.9), p = 0.0065] and at week 24 [-5.3 ([+ or -]4.4) vs -9.2 ([+ or -]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 ([+ or -]3.3) vs -2.1 ([+ or -]3.8), p = 0.9004; HAD-D, -1.0 ([+ or -]3.3) vs -1.5 ([+ or -]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. Keywords: psoriasis, biologics, interleukin-17A, secukinumab, elderly
Introduction Psoriasis is a common inflammatory, immune-mediated skin disease; its prevalence tends to increase with age. (1-3) Due to the steadily increasing number of people aged [greater than or equal [...]