New phase III psoriasis data show significant skin clearance with Novartis’ secukinumab

Novartis has announced the results from the pivotal phase III Feature and Juncture studies showing secukinumab (AIN457), an interleukin-17A (IL-17A) inhibitor, demonstrated consistent high efficacy when administered with a convenient pre-filled syringe (PFS) or autoinjector/pen (AI)[1],[2].These results, along with patient-reported outcomes showing high patient satisfaction with PFS and AI[3],[4], were presented for the first time at the 72nd Annual Meeting of the American Academy of Dermatology (AAD) in Denver, US.

Feature and Juncture are the first phase III studies to evaluate secukinumab in clearing patients’ skin with the PFS and AI administration[1],[2]. Both methods allow secukinumab self-administration anywhere (including the workplace or home) versus healthcare professional administration, if allowed by local regulations. This is important because many psoriasis patients prioritize easy self-administration at a location of their choice[6].

“It is important that people living with psoriasis, a chronic skin disease, have highly effective and safe treatments they can conveniently self-administer,” said Tim Wright, Global Head of Development, Novartis Pharmaceuticals. “These exciting results from our speciality dermatology portfolio show that secukinumab, the first IL-17A inhibitor with regulatory submissions completed, had similar efficacy in clearing skin with a convenient pre-filled syringe and autoinjector pen as in the landmark Fixture study, where it was significantly superior to Enbrel, a biologic psoriasis therapy approved 10 years ago.”

Importantly, in both studies more secukinumab 300 mg patients experienced almost clear skin, described as Psoriasis Area and Severity Index 90 (PASI 90), at Week 12 (60.3 per cent for Feature and 55 per cent for Juncture, p<0.0001) compared to placebo[1],[2]. PASI 90 is considered the best evidence of efficacy, and a more robust measure of the extent of skin clearance compared to standard efficacy measures that have been used in most psoriasis clinical studies, such as PASI 75[7].

The Feature and Juncture studies met all primary and pre-specified secondary endpoints[1],[2]. Across the co-primary endpoints in both studies, secukinumab 300 mg demonstrated significant improvements in PASI 75 at Week 12 versus placebo (75.9 per cent vs. zero per cent for Feature; 86.7 per cent vs. 3.3 per cent for Juncture, p<0.0001), and was also superior to placebo according to the Investigator’s Global Assessment (IGA mod 2011)[1],[2].

Patients also benefitted from rapid and significant skin clearance with secukinumab in both studies[1],[2]. Already by the third week, patients taking secukinumab 300 mg experienced superior efficacy in clearing skin compared to placebo[1],[2]. In addition, the 300 mg dose showed numerically and clinically relevant improvements compared to 150 mg[1],[2].

Both studies measured usability and patient satisfaction with secukinumab delivered via PFS and AI[3],[4]. On the first week, all patients successfully self-injected secukinumab by following instructions, with no administration issues observed[3],[4]. Patient satisfaction scores were consistently high, showing acceptability of the PFS and AI[3],[4]. Satisfaction was assessed using a self-administered Self-Injection Assessment Questionnaire (SIAQ), which measures overall experience, feelings about injections, self-confidence, satisfaction with self-injection, injection-site reactions, ease of use, and self-image before and after treatment[3],[4].

Secukinumab demonstrated a positive safety profile consistent with findings from previous studies, with adverse events (AEs) similar between both secukinumab treatment arms (300 mg and 150 mg)[1],[2]. In Feature, the most common AEs in any treatment group were diarrhoea, nasopharyngitis and headache[1]. In Juncture, the most common AEs in any treatment group were nasopharyngitis, headache and pruritus[2]. There were no deaths reported during either study, and no new or unexpected safety findings were observed[1],[2].

The Feature and Juncture results support the head-to-head phase III Fixture data first presented in October 2013, which showed secukinumab cleared skin faster and for longer than Enbrel(etanercept)[5]. Clinically relevant differences were observed as early as the second week in Fixture, and by week 16 nearly three quarters (72 per cent) of secukinumab 300 mg patients experienced almost clear skin (PASI 90)[5]. Secukinumab efficacy was also sustained over the full one year study, with significantly more secukinumab 300 mg patients experiencing PASI 90 at Week 52 compared to Enbrel (65 per cent vs. 33 per cent)[5].

EP News Bureau – Mumbai