Secukinumab provides faster, more sustained relief from psoriasis-related pain, itching, and scaling than ustekinumab in subjects with moderate-to-severe plaque psoriasis



Introduction: CLEAR is a phase 3b study comparing secukinumab (an anti-IL-17A monoclonal antibody (mAb)) to ustekinumab (an anti-IL-12/23 mAb), in adults with moderate-to-severe plaque psoriasis. This analysis evaluates the long-term impact of treatment on patient-reported assessments of psoriasis-related pain, itching, and scaling over 52 weeks.
Materials and Methods: 676 subjects were randomized 1:1 to secukinumab or ustekinumab. Psoriasis-related pain, itching, and scaling over the last 24 hours were assessed using a 0-10 numerical rating scale (higher scores indicating greater severity). Assessments were administered weekly from baseline up to week 4, every 4 weeks up to week 28 and also at weeks 48 and 52. Mean change in scores for pain, itching, and scaling and the proportion of subjects reporting complete relief were assessed.
Results: At Weeks 16 and 52, the mean reduction from baseline in subject's assessment of pain, itching, and scaling was significantly greater for secukinumab than ustekinumab (Week 16: pain: -3.07 vs. -2.81; itching: -4.97 vs. -4.57; scaling: -5.62 vs. -5.14; Week 52: pain: -3.02 vs. -2.56; itching: -4.88 vs. -4.27; scaling: -5.41 vs. -4.68; all P<0.05). The complete relief rate of pain, itching, and scaling was also significantly higher among patients treated with secukinumab than those treated with ustekinumab (Week 16: pain: 69.1% vs. 56.7%, itching: 49.7% vs. 36.7%, scaling: 61.0% vs. 42.4%; Week 52: pain: 65.6% vs. 55.9%, itching: 46.3% vs. 38.4%, scaling: 52.7% vs. 37.4%; all P<0.05).
Conclusion: Secukinumab achieves significantly greater relief from patient-reported psoriasis-related pain, itching, and scaling than ustekinumab.


Prof. Rod Sinclair