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Summer 2016, Vol. 24 No. 2

Hong Kong J. Dermatol. Venereol. (2016) 24, 93


Reports on Scientific Meetings

Raise the bar: aim for PASI 100

Reported by WH Leung 梁衛紅

Date:   17 March 2016
Venue:  

Harlan's, The One, 100, Nathan Road, Tsimshatsui, Kowloon, Hong Kong

Organiser:   The Hong Kong Society of Dermatology and Venereology and The Hong Kong College of Dermatologists

Aim for Clear - Is PASI 90/100 a realistic goal?

Speaker: Chi-keung Yeung
Dermatologist in Private Practice, Hong Kong

Treatment of psoriasis aims at reducing clinical symptoms, decreasing clinical severity and its impact on quality of life, as well as extending the remission period. Traditionally, clinical trials in psoriasis utilise various outcome measures such as Psoriasis Area Severity Index 75 (PASI 75) and Dermatology Quality of Life Index (DLQI). In a survey performed by Queen Mary Hospital assessing the psychological burden of psoriasis amongst patients, it was noted that moderate-to-severe psoriasis was associated with significantly higher self-perceived disease severity (P<0.01) compared to those with mild disease. The perceived disease impacted on six areas of life: emotion, social life, general physical health, economy, job opportunity and work, and family life. Nearly half (48%) of the patients were dissatisfied with their current treatment. The main reasons were lack of treatment efficacy (58%), side-effects (29%), and high cost (20%). Eighty-four percent of patients preferred a more aggressive approach. These findings are similar to those of overseas studies.

Secukinumab is the newest biologic agent that has become available in Hong Kong. It is an anti-IL-17A agent approved for use in patients with moderate-to-severe psoriasis. Secukinumab (79.0%) was superior to ustekinumab (57.6%) as assessed by PASI 90 response at week 16 (P<0.0001). The 100% improvement from baseline PASI score at week 16 was also significantly greater with secukinumab (44.3%) than ustekinumab (28.4%) (P<0.0001). The 75% or more improvement from baseline PASI score at week 4 was superior for secukinumab (50.0%) versus ustekinumab (20.6%) (P<0.0001). Percentage of subjects with the Dermatology Life Quality Index score 0/1 (week 16) was significantly higher with secukinumab (71.9%) than ustekinumab (57.4%) (P<0.0001). The safety profile of secukinumab was comparable with ustekinumab.

Learning points:
Secukinumab is an anti-IL-17A agent approved for use in patients with moderate-to-severe psoriasis. Secukinumab is demonstrated to be superior to ustekinumab as assessed by PASI 90 response at week 16.