Findings from the Shanghai Psoriasis Effectiveness Evaluation CoHort, published in Dermatologic Therapy, emphasize secukinumab’s potential to enhance both clinical and emotional well-being in psoriasis patients.
The multicenter prospective cohort study, conducted by Min Dai and colleagues from the Department of Dermatology at Shanghai Skin Disease Hospital, Tongji University School of Medicine, aimed to compare the clinical and psychological outcomes of secukinumab and ixekizumab in a real-world Chinese psoriasis population. Both drugs are IL-17A inhibitors widely used for treating moderate-to-severe psoriasis, yet direct comparisons of their effects on psychological health remain limited.
A total of 282 patients were enrolled, with 176 receiving secukinumab and 106 receiving ixekizumab. Key clinical and psychological outcomes were assessed at baseline and after 12 weeks of treatment, including Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA), Dermatology Life Quality Index (DLQI), Patient Global Assessment (PtGA), and Hospital Anxiety and Depression Scale (HADS). HADS measurements included both achieving complete remission in anxiety or depression (HADS-A or HADS-D = 0) and changes in scores from baseline.
The study showed the following findings:
- Both secukinumab and ixekizumab achieved similar clinical responses at Week 12.
- Rates of PASI 75, PASI 90, and PGA 0/1 responses did not differ significantly between the two groups.
- Secukinumab-treated patients were more likely to achieve complete remission of anxiety symptoms (HADS-A = 0: 49% vs. 28%).
- Secukinumab-treated patients were more likely to achieve complete remission of depression symptoms (HADS-D = 0: 31% vs. 19%).
- Reductions in HADS-A and HADS-D scores from baseline were greater in the secukinumab group.
- Subgroup analyses showed that the psychological benefits of secukinumab were consistent across different clinical characteristics.
The study authors note several limitations, including potential selection bias inherent to observational studies, unmeasured confounders, and the short-term nature of the analysis, limited to 12 weeks. They emphasize that longer-term studies are necessary to fully understand the psychological and clinical effects of these biologics over time.
The authors note, "While secukinumab and ixekizumab provide comparable clinical control of moderate-to-severe psoriasis, secukinumab appears to offer greater psychological benefits, particularly in reducing anxiety and depression."
"These findings underline the importance of integrating mental health assessment into psoriasis management and suggest that treatment decisions should consider both physical and emotional outcomes. Future research is needed to explore the mechanisms driving these psychological improvements and their long-term impact on patient well-being," they concluded.
Reference:
Dai, M., Jiang, Y., Wang, Y., Huang, D., Hu, Y., Wang, S., & Shi, Y. (2024). Comparative Efficacy of Secukinumab and Ixekizumab on Clinical and Psychological Outcomes in Psoriasis Patients: A Multicenter Prospective Cohort Study. Dermatologic Therapy, 2025(1), 7025415. https://doi.org/10.1155/dth/7025415
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