Presenting Author:

Erin Ibler, M.D.

Principal Investigator:

Beatrice Nardone

Department:

Dermatology

Keywords:

secukinumab, psoriasis, biologic, infection

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C16 - Clinical

Rate of infection for secukinumab versus other biologic agents

Introduction Biologic agents, including anti-tumor necrosis factor (TNF) alpha inhibitors and interleukin (IL) 12/23 inhibitors, are now widely used in the management of moderate to severe psoriasis. The rate of infection in patients prescribed these medications has been shown to be comparable. However, the rate of infection in patients on newer agents, such as recently-introduced anti IL 17A agent secukinumab, remains less well-characterized. The full prescribing information for secukinumab described infection in 28.7% of plaque psoriasis subjects treated with this medication. Therefore, the rate of infection occurring in a large single center U.S. patient population during exposure to secukinumab was investigated as compared to other biologic agents for psoriasis. Methods We utilized a large, urban, single-center electronic medical record database to collect data for all patients aged 18-89 years who had a prescription for adalimumab, etanercept, infliximab, ustekinumab and secukinumab between January 2015 and August 2016. Within this group, data was collected for patients who developed infection (defined by ICD9 codes) after the first dose of one of these biologic agents. Patients with one or more agents’ prescriptions were included in the analyses. The infection rate in the population exposed to secukinumab was compared to the infection rate for other biologic agents by using the univariate analyses of variance. Results The search retrieved a total of a 1,047 individual subjects with a total of 1,220 prescriptions of which 103 secukinumab, 44 infliximab, 534 adalimumab, 239 etanercept and 300 ustekinumab. The rate of infection for each agent was: secukinumab (N= 4, 3.9%), infliximab (N= 2, 4.5%), adalimumab (N=8, 1.5%), etanercept (N=3, 1.3%), ustekimumab (N=8, 2.7%). No significant difference in the infection rate between secukinumab and all other biologic agents was detected. Conclusions Findings in this large patient population indicate that secukinumab, a recently introduced first in its class agent targeting IL-17A for the management of moderate to severe psoriasis, demonstrated no significant difference in rate of infection compared to other biologic agents and likewise provides an acceptable benefit to risk ratio for its intended use in psoriasis. However, further post-marketing studies with large sample sizes are warranted.