Secukinumab 300mgs is more efficacious than ustekinumab 90mgs: Analysis of patients with body weights over 100kg from the CLEAR study

Introduction: Obesity is a frequent comorbidity in patients with psoriasis. In the CLEAR study, secukinumab, an anti-IL-17A monoclonal antibody, demonstrated superior PASI90, PASI75, PASI100 and IGA mod 2011 responses at 16 weeks when compared to ustekinumab, in patients with moderate to severe plaque psoriasis. Here we present an analysis of these responses in the subgroup of patients with a body weight >100 kg.
Materials and Methods: 676 patients were randomized to either secukinumab 300mg or ustekinumab 45 or 90mg (45mg in patients ≤100 kg and 90mg in patients >100kg). The randomization was stratified by body weight (≤100 or >100 kg). PASI90 (primary endpoint), PASI75, PASI100 and IGA mod2011 (IGA) were analyzed in the first 16 weeks of the study for the >100kg subgroup. Missing values were assigned as non-responders for all patients included in this pre-planned analysis.
Results: Patients with a body weight >100 kg at baseline (n=78 for secukinumab and n=83 for ustekinumab), had PASI90, PASI75, PASI100 and IGA responses at week 16 of 64.1%, 84.6%, 30.8% and 73.1% with secukinumab 300mg and 48.2%, 80.7%, 14.5% and 60.2% with ustekinumab 90mg, respectively. In this subgroup, secukinumab 300mg demonstrated a significantly higher PASI90 response at week 16 compared with ustekinumab 90mg (p=0.042). Secukinumab also demonstrated a statistically significantly higher PASI75 and IGA response at week4 (p=0.021 and p=0.003) and PASI100 at week16 (p=0.013).
Conclusion: Secukinumab 300mg demonstrated a clinically and statistically significantly higher efficacy (PASI90 at week16) than ustekinumab 90mg in patients with a body weight over 100kg.

Dr. Lynda Spelman