Secukinumab compared to ixekizumab in biologic-naïve Chinese individuals afflicted with moderate-to-severe plaque psoriasis: A retrospective single-center analysis

The clinical benefits of interleukin (IL)-17A therapies for psoriasis are well-substantiated. However, efficacy outcomes for moderate-to-severe plaque psoriasis (pPS) may vary across IL-17A treatments. Practitioners require evidence to guide treatment selection within the IL-17A class for biologic-naïve patients with moderate-to-severe pPS. This study compares the effectiveness and safety of ixekizumab and secukinumab in such patients. A retrospective analysis of 5 years of electronic medical records (demographics, clinical characteristics, treatment outcomes, and adverse effects) was conducted on biologic-naïve patients receiving IL-17A treatments for moderate-to-severe stable pPS. The study comprised 70 ixekizumab users (ET cohort) and 55 secukinumab users (SB cohort) from a single center. Concurrent therapies were evenly distributed across groups. Both cohorts exhibited significant reductions in percentage body surface area involvement and Psoriasis Area and Severity Index scores posttreatment (P < .001 for all). However, the SB cohort demonstrated greater reductions in percentage body surface area involvement (P < .001) and Psoriasis Area and Severity Index scores compared with the ET cohort. Physician Global Assessment of treatment response favored the SB cohort (1.1 [1.4-1] vs 1.1 [1.5-1]). Systemic organ infections were more prevalent in the SB cohort (P = .009). Following treatment, 26 (37%) and 24 (44%) patients in the ET and SB cohorts, respectively, achieved mild disease activity (≤1 on Physician Global Assessment). The SB cohort experienced a higher incidence of adverse effects (P < .001, risk ratio = 0.52; 95% confidence interval = 0.37-0.73, I2 = 0%). In Chinese biologic-naïve patients with moderate-to-severe pPS, secukinumab may be associated with a superior response but a higher incidence of adverse effects compared with ixekizumab.