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Off-Label High-Dose Secukinumab for the Treatment of Moderate-to-Severe Psoriasis.
Phung, Michelle; Ighani, Arvin; Georgakopoulos, Jorge R; Vender, Ron; Giroux, Lyne; Lansang, Perla; Yeung, Jensen.
Afiliación
  • Phung M; 1 Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, ON, Canada.
  • Ighani A; 2 Faculty of Medicine, University of Toronto, ON, Canada.
  • Georgakopoulos JR; 3 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
  • Vender R; 4 Dermatrials Research Inc, Hamilton, ON, Canada.
  • Giroux L; 5 Venderm Innovations in Psoriasis, Hamilton, ON, Canada.
  • Lansang P; 6 Department of Dermatology, The Northern Ontario School of Medicine, Sudbury, Canada.
  • Yeung J; 7 Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
J Cutan Med Surg ; 23(4): 391-393, 2019.
Article en En | MEDLINE | ID: mdl-30991818
BACKGROUND: Secukinumab is an anti-IL-17A monoclonal antibody approved for the treatment of moderate-to-severe psoriasis in adult patients. Despite its favourable safety and efficacy profile in clinical trials, some patients in clinical practice fail to respond adequately to the approved maintenance regimen of 300 mg subcutaneous monthly. Some clinicians manage these patients by using off-label high-dose secukinumab regimens, which include shortening the dosing interval to 300 mg every 2 or 3 weeks instead of monthly, or increasing the monthly dose to 450 mg. OBJECTIVE: This study aims to investigate the safety and efficacy of high-dose secukinumab regimens for the treatment of psoriasis to inform real-world clinical practice. METHODS: We performed a retrospective chart review at 5 dermatology clinics for adult patients diagnosed with moderate-to-severe psoriasis treated with an off-label high-dose secukinumab regimen. Efficacy was measured using the Psoriasis Area and Severity Index or a Physician Global Assessment score of 0 or 1 after dose escalation. Adverse events were recorded to assess safety outcomes. RESULTS: Twenty-five patients were included in this case series, and 14 of them achieved efficacy from dose escalation with secukinumab based on our study endpoints. There was 1 case of the common cold and 1 upper respiratory tract infection reported after dose escalation. CONCLUSION: Our study provides evidence that dose escalation with secukinumab results in clinical benefit and is well tolerated among patients with moderate-to-severe psoriasis who failed to respond adequately to the approved regimen. This work necessitates larger studies to fully characterize the efficacy and long-term safety profile of secukinumab dose escalation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psoriasis / Fármacos Dermatológicos / Anticuerpos Monoclonales Humanizados Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Cutan Med Surg Asunto de la revista: DERMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psoriasis / Fármacos Dermatológicos / Anticuerpos Monoclonales Humanizados Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Cutan Med Surg Asunto de la revista: DERMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos