Secukinumab is effective and safe in the treatment of recalcitrant palmoplantar psoriasis and palmoplantar pustular psoriasis in a daily practice setting.
Background: Palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPPP) are frequently recalcitrant to treatment. Currently, we have limited information from guidelines for their management. Objective: To study drug effectiveness, safety and persistence as well as quality of life in patients with PP and PPPP treated with secukinumab (SEK) in real clinical practice. Methods: Retrospective, observational, non-controlled, multicenter cohort, long-term study of patients with moderate-to-severe PP and PPPP (ppIGA/pppIGA score ≥3) treated with SEK under daily practice conditions between January 2014-July 2020. Results: Seventy-two patients (55 PP, 17 PPPP) were included. A 56.36% and 52.94% of PP and PPPP patients, respectively, achieved ppIGA/pppIGA response scores of 0/1 or a reduction of at least 2 points on the ppIGA/pppIGA scale from baseline in the 24-month follow-up. We found statistically significant differences in ppIGA at 12 months between naïve subjects and patients with prior biologic therapy, with greater effectiveness in naïve patients. Mean drug survival for PP and PPPP patients were 12.7 and 13.4 months; respectively. Limitations: Those derived from the retrospective and multicenter nature of the study. Conclusion: Secukinumab is a safe, fast and effective treatment alternative for some patients with PP and PPPP refractory to previous systemic or biologic treatments.