Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial

The 16-week primary endpoint results from the CLEAR study (currently ongoing) show that secukinumab was associated with a higher PASI 90 response than ustekinumab in patients with moderate to severe plaque psoriasis (79.0% v 57.6%, respectively; p<0.0001).

Secukinumab (Cosentyx®) was recently approved for the treatment of adult patients with moderate to severe plaque psoriasis. In DRAFT guidance (final appraisal determination), NICE has recommended its use as an option for treating adults with plaque psoriasis only when:

 

• the disease is severe, as defined by a total Psoriasis Area Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10

• the disease has failed to respond to standard systemic therapies, for example, ciclosporin, methotrexate and PUVA, or these treatments are contraindicated or the person cannot tolerate them

• the company provides secukinumab with the discount agreed in the patient access scheme

 

Final guidance is due to be published in July 2015.

These draft recommendations are similar to those for ustekinumab in psoriasis, outlined in guidance published in 2009 (TA180).