Efficacy of interleukin-17 inhibitors in psoriasis patients: a comparative non-randomized study

Background. IL-17 blockers have expanded the possibilities of psoriasis therapy. Their high efficacy and safety profile have been demonstrated in phase I–III studies and in real-world clinical practice. No direct comparative studies of the efficacy of drugs of this class registered in the Russian Federation have been conducted. Aims. To compare the efficacy of psoriasis therapy using netakimab and secukinumab in real clinical practice. Methods. A non-randomized comparative study of the efficacy of netakimab and secukinumab in patients with moderate to severe psoriasis was conducted. The study included 46 patients receiving therapy with IL-17 blockers (secukinumab, netakimab). The observation duration was 25 weeks. The proportions of patients who achieved PASI 100/90/75/50 values by 3, 12, 16 and 25 weeks from the start of therapy and the relative changes in PASI and BSA values were compared. Results. 26 patients received secukinumab and 20 patients received netakimab therapy. The groups were comparable in clinical and demographic parameters. Due to therapy inefficiency, the study was terminated early in 1 patient in the secukinumab group and 2 patients in the netakimab group. Adverse events were not registered in either group. By week 25 of therapy, the proportion of patients with PASI 100/90/75/50 in the secukinumab group was 30,8/65,4/84,6/92,3% and 35/55/85/100% in the netakimab group, respectively. There was no statistically significant difference in the proportion of patients with PASI 100/90/75/50 within 25 weeks from the start of therapy (p = 0.515; p = 0.782; p = 0.972; p = 0.016). By the end of each additional week from the start of therapy, the mean PASI value with secukinumab therapy decreased by 25.8% (95% CI: 21.3–30.2; p 0.001), with netakimab therapy by 22.0% (95% CI: 17.7–26.4; p 0.001). Conclusion. The proportion of patients achieving PASI 100/90/75/50 after 25 weeks of secukinumab and netakimab therapy was similar, with no statistically significant differences. The differences in the rate of PASI reduction between secukinumab and netakimab therapy were also no statistically significant.