Background
Secukinumab is administered at the labelled dose of 300 mg at weeks 0, 1, 2, 3, 4 (loading dose) and every 4 weeks thereafter.
Objective
To investigate the efficacy of secukinumab administered without the initial loading dose in patients with psoriasis.
Materials and Methods a retrospective, observational study including adult patients with psoriasis (n=156) treated with secukinumab 300 mg administered either according to the labelled dose (n=75) or without the initial loading dose (n=81). Efficacy was evaluated by comparing the PASI 75 and PASI 90 response rates at week 8, 12, 16, 32 and 48.
Results
PASI 75 response rates were achieved at week 8, 12, 16, 32 and 48 by 60.01% and 40.20% (p<0.01), 72.22% and 60.61% (p<0.01), 77.35 and 74.68%, 85.14% and 77.19%, 78.57% and 77.59% of those who received the labelled dose versus those who did not, respectively. PASI 90 response were achieved at the same time points by 45.10% and 30.50% (p<0.01), 49.37% and 40.30% (p<0.01), 54.44% and 46.67%, 54.65% and 47.37%, 56.9% and 54.29% of those who received the labelled dose versus those who did not, respectively. A greater proportion of patients receiving secukinumab without the loading dose discontinued it because of inefficacy (24.6% vs 13.3%, p<0.05), particularly those with body weight greater than 80 kg.
Conclusions
Secukinumab administered without the loading dose is associated with a higher proportion of primary inefficacy, and it is inferior compared to the labelled dose at week 8 and 12, but with similar efficacy thereafter. ClinicalTrials gov identification number NCT03828643.
