Lack of reactivation of tuberculosis in patients with psoriasis treated with secukinumab in a real-world setting of latent tuberculosis infection.

Abstract

BACKGROUND:

Some biologics for psoriasis, especially anti-tumor necrosis factor (TNF)-α therapies, may re-activate latent tuberculosis (TBC) infection with consequent morbidity and mortality. However, there is a low reported incidence of conversion to positive TBC status among patients with psoriasis treated with second-generation biologic therapies, particularly anti-interleukin (IL)-17 therapies such as secukinumab.

OBJECTIVES:

To evaluate the safety profile of secukinumab in psoriasis patients with latent TBC infection.

METHODS:

Real-life data were collected by retrospective chart review on patients with moderate-to-severe psoriasis who showed positivity for TBC screening at baseline and underwent secukinumab treatment for psoriasis at six Italian centers. Patients received secukinumab 300 mg at week 0/1/2/3/4, then every 4 weeks.

RESULTS:

Fifty-nine patients were enrolled; 30.5% also had psoriatic arthritis and other comorbidities were common. At baseline, the mean psoriasis duration was 14.5 years. Ten (17%) patients did not undergo prophylaxis before starting secukinumab. Conversely, isoniazid ± rifampicin or rifampicin alone prophylaxis was administered in 49/59 (83.1%) patients. After a mean treatment duration of 84 weeks, there were no cases of TBC reactivation and no unexpected safety signals.

CONCLUSIONS:

Secukinumab use over an extended period was safe in psoriasis patients with latent TBC, even in patients who did not receive chemoprophylaxis.

• Authors: Matteo Megna, Cataldo Patruno, Maria Rita Bongiorno, Alessio Gambardella, Claudio Guarneri, Caterina Foti, Serena Lembo, Francesco Loconsole, Gabriella Fabbrocini
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 33 Issue 5 Pg. 2629-2633 (Aug 2022) ISSN: 1471-1753 [Electronic] England
• PMID: 35385362 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• secukinumab
• Isoniazid
• Rifampin

Topics

• Antibodies, Monoclonal, Humanized
• Humans
• Isoniazid
• Latent Tuberculosis (diagnosis, drug therapy)
• Psoriasis (complications, drug therapy, pathology)
• Retrospective Studies
• Rifampin (therapeutic use)
• Severity of Illness Index
• Treatment Outcome
• Tuberculosis