Clinical Scorecard: Evaluating the Safety and Efficacy of Switching to Alternative Biologics Following Secukinumab Treatment Failure in Patients with Moderate-to-Severe Plaque Psoriasis: A Retrospective Cohort Analysis

At a Glance

Key Highlights

• Ixekizumab showed higher PASI 75 response rates at week 12 compared to guselkumab and ustekinumab.
• Adverse event rates were mild and did not require treatment discontinuation.
• Guselkumab offers gradual but sustained improvement.
• The choice of switching strategy should consider failure type and patient preference.

Guideline-Based Recommendations

Diagnosis

• Diagnosis of moderate-to-severe plaque psoriasis according to the Chinese Guidelines for Psoriasis Diagnosis and Treatment.

Management

• Switching to ixekizumab, guselkumab, or ustekinumab after secukinumab failure.

Monitoring & Follow-up

• Follow-up for at least 12 weeks after switching to assess treatment response.

Risks

• Adverse events associated with ixekizumab, guselkumab, and ustekinumab were reported, with rates of 28.6%, 12.5%, and 33.3%, respectively.

Patient & Prescribing Data

59 patients who switched from secukinumab to alternative biologics.

Ixekizumab may offer advantages in short- to mid-term effectiveness, particularly in secondary failure.

Clinical Best Practices

• Consider the type of treatment failure (primary vs. secondary) when selecting a subsequent biologic.
• Integrate patient preference and drug-specific characteristics into treatment decisions.

Related Resources & Content

• Chinese Guidelines for Psoriasis Diagnosis and Treatment