Secukinumab shows significant efficacy in nail psoriasis: Week 32 results from the TRANSFIGURE study

Introduction: TRANSFIGURE is a phase 3b study designed to evaluate the efficacy and safety of secukinumab (an anti-IL-17A monoclonal antibody) in patients with moderate to severe psoriasis with significant nail involvement. Here we report the 32-week data.
Materials and Methods: 198 patients were randomized 1:1:1 to receive either secukinumab 300mg/150mg/placebo up to Week 128. At Week 16, all subjects receiving placebo were re‐randomized 1:1 to receive 300mg/150mg secukinumab. Efficacy was assessed by measuring the Nail Psoriasis Severity Index (NAPSI) of fingernails (sum of NAPSI scores from all 10 fingernails; total score 0-80) at Week 16 and Week 32. Impact on quality of life was assessed by Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA) Patient Benefit Index (‐PBI) and Quality of Life (‐QOL) at Week 16.
Results: The primary objective of this study was met. Both doses of secukinumab were superior to placebo at Week 16 (mean NAPSI improvement from Baseline: ‐45.3%/‐37.9%/‐10.8%, for secukinumab 300mg/150mg/placebo, respectively (P < 0.0001)). Responses improved further by Week 32 with a total fingernail NAPSI change of ‐63.2%/‐52.6%, for secukinumab 300mg/150mg, respectively. At Week 16, patients showed significant improvements in NAPPA‐QOL with a median decrease in total score of 60.9%/49.9%/15.8% for secukinumab 300mg/150mg/placebo, respectively. The percentage of subjects achieving a weighted NAPPA‐PBI global score of 2 and above (i.e. moderate benefits) was 75.4%/61.3%/8.6% for secukinumab 300mg/150mg/placebo, respectively. The safety profile was similar to other secukinumab phase 3 studies.
Conclusion: Secukinumab demonstrated significant efficacy, quality of life improvement and patient‐reported benefit in nail psoriasis.

Dr. John Sullivan