This study compared Cosentyx (secukinumab) with narrow band ultraviolet B (nb-UVB) phototherapy in new onset moderate to severe plaque psoriasis patients.

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Background:
Biologic treatments have been studied mainly in patients with a long-term history of psoriasis and previous treatment failures.

Objectives:
The purpose of this primary analysis of the STEPIn study is to determine whether early intervention with secukinumab in patients with new-onset moderate to severe plaque psoriasis is superior to standard of care treatment with narrow band ultraviolet B (nb-UVB) phototherapy.

Methods:
The STEPIn study is a randomised, open-label, multicentre study to investigate early intervention with 52 weeks of secukinumab 300 mg administered subcutaneously vs. standard treatment with nb-UVB phototherapy in patients with new-onset (≤12 months) moderate to severe plaque psoriasis (NCT03020199). The primary and additional secondary endpoints were ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at Week 52 and Investigator's Global Assessment (IGA mod 2011) 0/1 response at Week 52, respectively.

Results:
In the secukinumab and nb-UVB study arms, 77/80 and 76/80 randomised patients received at least one dose of study treatment, respectively. The primary endpoint was achieved: 91.1% (70/77) of patients achieved a PASI 90 response at Week 52 in the secukinumab arm vs. 42.3% (32/76) in the nb-UVB arm (P<0.0001, odds ratio [OR] estimate [95% confidence intervals, CI] = 16.3 [5.6, 46.9]). The additional secondary endpoint was also achieved: 85.7% of patients achieved an IGA 0/1 response at Week 52 in the secukinumab arm vs. 36.8% in the nb-UVB arm (P<0.0001). The safety data were consistent with the safety profiles of secukinumab and nb-UVB with no new or unexpected safety signals.

Conclusions:
Secukinumab was superior to nb-UVB in treating patients with new-onset moderate to severe plaque psoriasis. The high and sustained skin clearance observed indicates that biologic treatment for psoriasis may be more effective if used early in the disease course.

Source: onlinelibrary.wiley.com

*Early view funding unknown

Cosentyx (secukinumab)

Huh my psoriasis was made much worse by being forced to have uvb and getting burned by it on areas I didn’t have any P.

No way are they ever going to change their current approach of giving us the cheapest worst drugs/ treatment first.

(Fri-13-01-2023, 17:04 PM)Turnedlight Wrote: No way are they ever going to change their current approach of giving us the cheapest worst drugs/ treatment first.

They do the same here TL, I can't help feeling it would be better and cheaper in the long run to go in with a bio on newly diagnosed. We all know the creams, light and poisons like methotrexate don't work and people will end up on a bio anyway eventually.

Hit hard first off with a bio and it may be possible to send it in remission with only a booster once per year, but hey they don't make money that way do they.