Cosentyx beats fumaric acid esters in psoriasis trial

[Fred]

Here's one that will get the DMF Gang talking. Coesntyx demonstrated superior efficacy to FAEs in patients with psoriasis over a 24 week period.

Quote:

---

Background:
Secukinumab is a fully human antibody that neutralizes interleukin-17A. It has significant efficacy and a favourable safety profile in moderate-to-severe plaque psoriasis and psoriatic arthritis.

Objectives:
To compare secukinumab with fumaric acid esters (FAEs) in a randomized controlled trial.

Methods:
In this 24-week, randomized, open-label, multicentre study with blinded assessment, patients with moderate-to-severe plaque psoriasis, naive to systemic treatments, were randomized to receive secukinumab 300 mg subcutaneously or oral FAEs. The primary end point was ≥ 75% improvement from baseline Psoriasis Area and Severity Index score (PASI 75 response) at week 24, and missing patients were considered responders if they were responders at the time of dropout.

Results:
In total 202 patients were randomized and 200 were treated with at least one dose. Outcomes at week 24 were available for 147 and imputed for 53 patients. Discontinuations were mostly due to adverse events, which occurred more frequently in the FAE group (1·9% vs. 33·0%). At week 24, significantly more patients receiving secukinumab compared with FAEs achieved PASI 75 response (89·5% vs. 33·7%, P < 0·001), PASI 90 response (81·0% vs. 28·4%, P < 0·001) and Dermatology Life Quality Index 0 or 1 response (71·4% vs. 25·3%, P < 0·001).

Conclusions:
Secukinumab demonstrated superior efficacy to FAEs in patients with psoriasis over a 24-week period.

Source: onlinelibrary.wiley.com

*Funding: Novartis

[jiml]

Here's one that will get the DMF Gang talking. Coesntyx demonstrated superior efficacy to FAEs in patients with psoriasis over a 24 week period.

Quote:

---

Background:
Secukinumab is a fully human antibody that neutralizes interleukin-17A. It has significant efficacy and a favourable safety profile in moderate-to-severe plaque psoriasis and psoriatic arthritis.

Objectives:
To compare secukinumab with fumaric acid esters (FAEs) in a randomized controlled trial.

Methods:
In this 24-week, randomized, open-label, multicentre study with blinded assessment, patients with moderate-to-severe plaque psoriasis, naive to systemic treatments, were randomized to receive secukinumab 300 mg subcutaneously or oral FAEs. The primary end point was ≥ 75% improvement from baseline Psoriasis Area and Severity Index score (PASI 75 response) at week 24, and missing patients were considered responders if they were responders at the time of dropout.

Results:
In total 202 patients were randomized and 200 were treated with at least one dose. Outcomes at week 24 were available for 147 and imputed for 53 patients. Discontinuations were mostly due to adverse events, which occurred more frequently in the FAE group (1·9% vs. 33·0%). At week 24, significantly more patients receiving secukinumab compared with FAEs achieved PASI 75 response (89·5% vs. 33·7%, P < 0·001), PASI 90 response (81·0% vs. 28·4%, P < 0·001) and Dermatology Life Quality Index 0 or 1 response (71·4% vs. 25·3%, P < 0·001).

Conclusions:
Secukinumab demonstrated superior efficacy to FAEs in patients with psoriasis over a 24-week period.

Source: onlinelibrary.wiley.com

*Funding: Novartis

It's a very small study 202 sufferers,  and it's  not a great surprise the results when you see who funded the study what the outcome would be
Yes I'm sure a lot of the FAE treated patients dropped out because of the side effects, and FAEs are known to take a long while to work, but I think the real test is of those that get clearance on either treatment which clearance lasts the longest ....and that is difficult to tell with Cosentyx as it is a relatively new drug

There is also the cost element to consider FAEs are considerably less costly than Cosentyx

I don't doubt Cosentyx is a great drug but it is far to costly to be made widely available to psoriasis sufferers ...and  I think Novataris are choosing a short time frame and a small sample to get the figures they would like

[Caroline]

1) good comment Jim
2) I am not surprised. Cosentyx blocks IL-17, DMF moderates.
3) They did not use Psorinovo. So more side effects. So more quitters.
4) let’s see the results in the study of 20 years of use.

[jiml]

1) good comment Jim  
2) I am not surprised. Cosentyx blocks IL-17, DMF moderates.
3) They did not use Psorinovo. So more side effects. So more quitters.
4) let’s see the results in the study of 20 years of use.

[Bill]

I have nearly five years with almost clear skin, a low esr, and very well controlled arthritis. Prior to this I had over two decades of a progressive and debilitating illness. I use DMF differently to the study, and I believe that the drug is more effective as I use it. Treatment cost is between $1US and $2US per year. The only difficulty I have is in maintaining an effective dose without knocking the lymphocyte count down too low. The only thing lacking with DMF is research to optimise its efficacy.

What would work as well for me? I have no incentive to find out.