Clinical Efficacy And Safety Analysis Of Secukinumab In The Treatment Of Plaque Psoriasis

Background:Psoriasis is a recurrent,inflammatory and systemic disease related to genetic,environmental and immune factors.The latest epidemiological survey of psoriasis in China shows that the prevalence of psoriasis in China is increasing year by year,and the north is higher than the south.Psoriasis patients are often accompanied by a great psychological burden.Disease and people ’s reactions greatly affect their daily life.In the past ten years,the birth of biological agents has made great progress in the treatment of psoriasis.Among biological agents,IL-17 A inhibitors are currently the best drugs for PASI90 response.Among IL-17 A inhibitors,Secukinumab can improve the quality of patients by quickly and clearly removing skin lesions.The study is open,controlled,and observational in nature.Secukinumab was subcutaneously injected into 369 patients who were collected with plaque psoriasis.plaque psoriasis are being treated with Secukinumab to observe its effectiveness and safety,and the efficacy and safety of 150 mg group and 300 mg group in the treatment of plaque psoriasis were analyzed.Objective:Evaluate the secukinumab’s clinical efficacy against plaque psoriasis,and make systematic assessments of its therapeutic effects and adverse reactions0.Methods:In January 2021 to November 2022,patients with plaque psoriasis who were admitted to the Second Hospital of Jilin University for Dermatology and who agreed to use secukinumab were collected.1.Secukinumab(regardless of dose)was injected subcutaneously.General information of patients,PASI score before treatment(baseline),PASI75,PASI90,PASI100,IGA0/1 response rate at 4th weeks,12 ed weeks,16 th weeks,24 th weeks and 52 ed weeks,DLQI score before treatment(baseline),DLQI0 / 1 response rate and adverse reactions at52 ed weeks were collected.Descriptive statistical analysis of the data obtained.2.According to the dosage,they were divided into 150 mg dose and300 mg dose.They were given injection of Secukinumab.The dosage was determined by the doctor according to body weight,previous treatment and economic conditions.The general data of patients,PASI score before treatment(baseline),PASI75,PASI90,PASI100,IGA0/1response rate at 4th weeks,12 ed weeks,16 th weeks,24 th weeks and 52 ed weeks,DLQI score before treatment(baseline),DLQI 0/1 response rate and adverse reactions at 52 ed week were collected.Analysis of 150 mg dose group and 300 mg dose group before treatment PASI score,PASI75,PASI90,PASI100,IGA0/1 response rate at 4th weeks,12 ed weeks,16 th weeks,24 th weeks and 52 ed week whether there are significant differences.Analyze whether there are significant differences in DLQI score before treatment(baseline)and DLQI 0/1 response rates at 52 weeks between 150 mg dose group and 300 mg dose group.The differences of adverse reactions between 150 mg dose group and 300 mg dose group were analyzed.3.When the PASI90 was achieved by regular subcutaneous injection of Secukinumab,the medication interval was appropriately prolonged.Whether the medication interval and the length of the interval began to be prolonged was determined by the doctor according to the improvement of skin lesions and adverse reactions and the patient ’s wishes.The general data of the patients,the PASI score before treatment(baseline),the time of regular application of secukinumab,the improvement rate of skin lesions after prolonged medication interval,adverse reactions were collected.Results:1.A total of 301 patients with regular injection of Secukinumab were collected.The response rate of PASI 75/90/100,IGA0/1 was 93.69 %,80.73 %,33.89 % and 75.42% at the 12 th week,87.38 %,76.41 %,42.86 % and 73.75% at the 52 nd week,and the response rate of DLQI0/1was 46.51 % at the 52 nd week.During the treatment,adverse reactions were found in 23 cases of upper respiratory tract infection,55 cases of pruritus,7 cases of headache and 7 cases of diarrhea.The adverse reactions were improved after symptomatic treatment.2.In comparison with the 300 mg group,there were no significant differences in the 150 mg group after 4,12,16,24,52 weeks of treatment(P > 0.05).3.No significant differences were found between the 150 mg and300 mg groups for DLQI 0/1 response rates after 52 weeks of treatment(P > 0.05).4.There was no significant difference in adverse reactions between150 mg group and 300 mg group after 52 weeks of treatment(P > 0.05).5.Among 25 patients with prolonged medication interval,13 patients reached PASI100 and stabilized for 6 months,and then were injected every 1.5-2 months.The other 12 patients had skin lesions improved by nearly PASI100,but the patient’s itching was obvious,and then the patient was asked to extend the medication interval,subcutaneous injection once every 1.5-3 months as appropriate(at the beginning of one and a half months of injection,the skin lesions were stable,and the injection interval was gradually extended.Two patients were extended to three months of injection).Prolonged dosing interval can be maintained until 12 weeks.At the 24 th week,there were 2 patients with decreased efficacy,and they achieved PASI100 response after restarting the intensive treatment,and then they were treated regularly once a month.The itching symptoms of 12 patients with prolonged medication interval were significantly improved and the skin lesions were stable after prolonged interval.Conclusion:1.After the treatment of plaque psoriasis,the skin lesions were significantly improved at 12 weeks and maintained for a long time to 52 weeks,and the quality of life can be improved and can be safe.2.For patients with light weight,or individual patients with poor economic conditions given regular subcutaneous injection of Secukinumab 150 mg,compared with regular subcutaneous injection of300 mg,both have good skin lesion clearance rate,improvement rate of life quality and similar safety.3.When the patient is subcutaneously injected with secukinumab regularly,the skin lesions are basically improved,and the medication interval can be appropriately prolonged.It can maintain the improvement of skin lesions and reduce the cost of treatment.4.Patients with pruritus after subcutaneous injection of secukinumab can try to prolong the medication interval to improve pruritus if the skin lesions can be improved.