Continued treatment with secukinumab is associated with high retention or regain of response.

Background Conventional analyses present aggregate data, masking late responders and efficacy reductions. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin (IL)-17A, shows sustained efficacy in moderate-to-severe psoriasis. Objectives To determine stability of response to secukinumab, changes in efficacy were assessed in individual patients. Methods This is a post hoc analysis of two phase III randomized controlled trials, FIXTURE (trial registration: NCT01358578) and CLEAR (trial registration: NCT02074982). Patients received secukinumab 300 mg (FIXTURE and CLEAR), etanercept 50 mg (FIXTURE) or ustekinumab 45 or 90 mg (CLEAR) over 52 weeks. Mutually exclusive response categories were defined: >= 90% improvement in the Psoriasis Area and Severity Index (PASI 90) ('excellent'), >= 75% improvement in PASI (PASI 75) and < PASI 90 ('good') and < PASI 75 ('insufficient'). Reductions in efficacy were defined as shifts from higher to lower response categories between two consecutive visits maintained for a third consecutive visit. Loss of efficacy was defined as a reduction of efficacy resulting in 'insufficient' response. All comparisons are descriptive. Results At 52 weeks, in CLEAR, 90 center dot 2% (303/336) of patients on secukinumab achieved stable efficacy without loss and 77 center dot 7% (261/336) showed stable efficacy without any reduction of response [74 center dot 3% (252/339) and 59 center dot 9% (203/339) of patients for ustekinumab]. In FIXTURE, 83 center dot 5% (273/327) and 66 center dot 4% (217/327) of patients on secukinumab had stable efficacy without loss or reduction of response [58 center dot 3% (190/326) and 42 center dot 6% (139/326) for etanercept]. Response was regained by continuing secukinumab treatment in 50% (8/16) of patients in CLEAR and 26% (9/34) in FIXTURE. Similar patterns were observed for other response definitions. Conclusions Efficacy with secukinumab was stable over 52 weeks of treatment in most patients. Continued treatment with secukinumab resulted in regain of efficacy in some patients. Persistent loss of response was uncommon.