Secukinumab shows significant efficacy in difficult‐to‐treat palmoplantar psoriasis: 1.5 year data from the GESTURE study

Introduction: Up to 40% of plaque psoriasis patients have palmoplantar involvement, often associated with pain, functional limitations, severe impact on patients’ quality of life and resistance to treatment. Secukinumab, an anti-IL-17A monoclonal antibody, has been used to treat patients with moderate to severe palmoplantar psoriasis in a phase 3b study; GESTURE. Here we report 1.5 year (week 80) efficacy and safety data.
Materials and Methods: 205 patients were randomized 1:1:1 to secukinumab 300mg or 150mg, or placebo, subcutaneously. At Week 16, subjects in the placebo arm were re‐randomized 1:1 to secukinumab 300mg or 150mg. The primary objective of GESTURE was to demonstrate superiority of secukinumab over placebo, as assessed by palmoplantar Investigator’s Global Assessment (ppIGA) 0/1 response at Week 16. Secondary objectives were the evaluation of ppIGA and palmoplantar Psoriasis Area and Severity Index (ppPASI) over time, and overall safety and tolerability of secukinumab.
Results: The primary and secondary endpoints of this study were met. At 16 weeks, 39.4% of patients receiving secukinumab 300mg had achieved a ppIGA 0/1 versus 1.5% in the placebo group (p<0.001). After 80 weeks 57.2% of patients receiving secukinumab 300mg had achieved a ppIGA 0/1. Furthermore, the mean ppPASI reduction from baseline improved after Week 16 and reached –68.5% by Week 80 for secukinumab 300 mg. Secukinumab was well tolerated with a safety profile similar to other pivotal secukinumab phase 3 studies.
Conclusion: Secukinumab displays significant efficacy in the treatment of palmoplantar psoriasis compared to a placebo.

A/Prof Peter Foley