SYNOPSIS
• Psoriasis is a chronic, systemic, immune-mediated 

disease of the skin that affects > 7.4 million people  
in the United States, with an estimated prevalence  
of 2% to 4%1

• Secukinumab is a fully human monoclonal antibody  
that selectively neutralizes interleukin (IL)-17A, a 
cornerstone cytokine involved in the development  
of psoriasis2

• Secukinumab has demonstrated efficacy in clinical  
trails and effectiveness in real-world settings in the 
treatment of patients with psoriasis3-9

• However, there remain limited real-world data 
characterizing US patients with psoriasis who  
initiate secukinumab in routine clinical practice

OBJECTIVE
• To describe demographic and clinical characteristics  

of US patients with plaque psoriasis who initiated 
secukinumab in clinical practice, using clinical data 
obtained from the Modernizing Medicine Data  
Services (MMDS) electronic medical records (EMRs) 
dermatology panel

METHODS
Study Design and Patient Population
• All data were collected from Modernizing Medicine’s 

Electronic Medical Assistant (EMA) system

 – EMA delivers structured, real-world data captured 
from > 500,000 unique patients with psoriasis

 – Data from EMRs for patients in the United States  
with a clinical diagnosis of psoriasis were  
deidentified in accordance with HIPAA (Health 
Insurance Portability and Accountability Act) for 
research use

• Eligible patients in the MMDS database had  
a diagnosis of plaque psoriasis during the study  
period of July 1, 2014, to March 31, 2018, had  
≥ 1 prescription order for secukinumab within the  
index period (January 1, 2015, to September 30, 2017), 
and were aged ≥ 18 years at the time of secukinumab 
initiation (index date)

• Patients had ≥ 1 clinical visit for any reason during  
the 6-month pre-index (baseline) period and  
≥ 1 clinical visit for any reason within the first and 
second 6 months following secukinumab initiation 
(12-month follow-up period)

Study Variables and Data Analysis 
• Demographic characteristics (age, sex, race, body 

weight, US region), treatment history (during 6-month 
pre-index period only), and clinical characteristics 
(comorbidities, psoriasis subtype, body surface area 
[BSA], and Physician Global Assessment [PGA]) were 
assessed by dermatology providers during the 6-month 
baseline period 

Demographic and Clinical Characteristics of  
Patients With Plaque Psoriasis Initiating 
Secukinumab in Clinical Practice: Data From  
US Dermatology Electronic Medical Records
Paul S. Yamauchi, MD, PhD,1 Chi-Chang Chen, PhD,2 Yao Ding, PhD,2 Rebecca Germino, PhD3
1UCLA School of Medicine, Santa Monica, CA; 2IQVIA, Plymouth Meeting, PA; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ

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Table 1. Demographics of Patients With Psoriasis Who  
Initiated Secukinumab and Had 12 Months of Follow-Up 

Characteristic
Patients With 12-Month  

Follow-Up
(N = 4996)

Age, mean (SD), years 51.6 (13.7)

Male, n (%) 2524 (50.5)

US region, n (%)

South 2070 (41.4)

West 1080 (21.6)

Midwest 1036 (20.7)

Northeast 802 (16.1)

Unknown 8 (0.2)

Race, n (%)

White 3317 (66.4)

Black 141 (2.8)

Asian 129 (2.6)

Hispanic 92 (1.8)

Other/unknown 1317 (26.4)

Index year, n (%)

2015 1131 (22.6)

2016 2096 (42.0)

2017 1769 (35.4)

Comorbidities and Treatment History During the 
Baseline Period 
• The most common comorbidities were hypertension 

(29.8%), psoriatic arthritis (22.2%), and diabetes  
(17.6%) (Table 2)

• Overall, 42.5% of patients received prior biologic 
treatment during the 6-month baseline period,  
of whom 54.0% received tumor necrosis factor  
inhibitors, 47.6% received ustekinumab, and  
3.2% received another IL-17A inhibitor (Table 2)

Table 2. Comorbidities and Treatment History of Patients 
With Psoriasis Who Initiated Secukinumab and Had 12 
Months of Follow-Up 

Characteristic
Patients With 12-Month 

Follow-Up
(N = 4996)

Comorbidities, n (%)

Hypertension 1487 (29.8)

Psoriatic arthritis 1110 (22.2)

Diabetes 877 (17.6)

Hyperlipidemia 751 (15.0)

Malignancies 633 (12.7)

Coronary heart disease 125 (2.5)

Cerebrovascular disease* 70 (1.4)

Obesity 55 (1.1)

Rheumatoid arthritis 24 (0.5)

Treatment history

Prior biologic treatment preceding 
secukinumab claim, n (%)

Tumor necrosis factor inhibitors† 1148 (54.0)

Ustekinumab 1011 (47.6)

IL-17A inhibitors‡ 69 (3.2)

IL, interleukin.
* Cerebrovascular disease included hemorrhagic stroke and transient ischemic attack. 
†  Tumor necrosis factor inhibitors included adalimumab, certolizumab pegol, etanercept, golimumab, 

and infliximab. 
‡ IL-17 inhibitors included brodalumab and ixekizumab. 

Clinical Characteristics During the Baseline Period 
• At baseline, the mean (SD) BSA was 23.0% (22.5%), 

and 58.1% had severe disease (BSA > 10%) (Figure 1A)

• The mean (SD) PGA score was 2.92 (1.19), and 72.0% 
had moderate-to-severe involvement (PGA score 3-5) 
(Figure 1B)

Figure 1. Categorical Clinical Outcome Measures* in  
Patients Who Initiated Secukinumab and Had 12 Months  
of Follow-Up 

BSA, body surface area; PGA, Physician Global Assessment. 
*  Available effectiveness records for PGA scores and BSA affected by psoriasis were reported  

based on the index visit or the visit closest to the index with such values during the 6-month 
baseline period. 

9.3%  
n = 191 

32.6% 
n = 670 

58.1% 
n = 1196 

Baseline BSA Category 

Baseline Categorical BSA (N = 2057) 

Mild (< 3%) Moderate (3%-10%) Severe (> 10%) 

Mean (SD), 23.0% (22.5%)  

4.0%  
n = 64 9.2% 

n = 149 

14.9% 
n = 241 

44.1% 
n = 714 

18.6% 
n = 301 9.3% 

n = 150 

Baseline PGA Category 

Baseline Categorical PGA (N = 1619) 

Clear (0) Minimal (1) Mild (2) Moderate (3) Marked (4) Severe (5) 

Mean (SD), 2.92 (1.19)  

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15 
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DISCLOSURES
P. S. Yamauchi has served as an investigator for Amgen, Celgene, Dermira, 
Galderma, Janssen, LEO Pharma, Eli Lilly, MedImmune, Novartis, Pfizer, 
Regeneron, and Sandoz and has served as an advisor and/or speaker for AbbVie, 
Amgen, Baxter, Celgene, Dermira, Galderma, Janssen, LEO Pharma, Eli Lilly, 
Novartis, Pfizer, and Regeneron. C.-C. Chen and Y. Ding are employees of IQVIA 
who received consulting fees to conduct this research. R. Germino is an employee 
of Novartis Pharmaceuticals Corporation.

ACKNOWLEDGMENTS
Support for third-party writing assistance for this poster, furnished by Meaghan 
Paganelli, PhD, of Health Interactions, Inc, was provided by Novartis 
Pharmaceuticals Corporation, East Hanover, NJ.
This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ.
© 2018 Novartis Pharmaceuticals Corporation.

LIMITATIONS
• The MMDS database included data captured only from 

physicians contributing to the EMR network (that was 
then de-identified), and results may not be generalizable 
to all patients with psoriasis 

• No continuous health plan enrollment information was 
captured in the EMR database 

• Patients with comorbid psoriatic arthritis or ankylosing 
spondylitis initiating secukinumab were not excluded 
from the study population, leading to potential 
confounding variables

CONCLUSION
• In this US real-world data analysis of patients with 

plaque psoriasis, most patients initiating secukinumab 
had moderate-to-severe disease, > 20% of patients had 
concomitant psoriatic arthritis, and the most common 
prior biologic treatment was tumor necrosis factor 
inhibitors during the 6-month baseline period

• Overall, these findings are consistent with patient 
characteristics and severity of psoriasis exhibited  
in clinical trials and provide additional insight into 
characteristics and treatment history of patients  
initiating secukinumab in real-world settings

REFERENCES
1. Rachakonda TD, et al. J Am Acad Dermatol. 2014;70(3):512-6.

2. Lynde CW, et al. J Am Acad Dermatol. 2014;71(1):141-50.

3. Langley RG, et al. N Engl J Med. 2014;371(4):326-38.

4. Blauvelt A, et al. Br J Dermatol. 2015;172(2):484-93.

5. Paul C, et al. J Eur Acad Dermatol Venereol. 2015;29(6):1082-90.

6. Thaci D, et al. J Am Acad Dermatol. 2015;73(3):400-9.

7. Armstrong AW, et al. J Clin Aesthet Dermatol. 2016;9(6 suppl 1):S12-6.

8. Mease P, et al. Ann Rheum Dis. 2018;77(6):890-7.

9. Bagel J, et al. Poster presented at: 27th European Academy of 
Dermatology and Venereology Congress; September 12, 2018; 
Paris, France [ePoster P1850].

RESULTS
Patient Demographics During the Baseline Period
• Of 803,036 patients in the MMDS database who had  

a diagnosis of plaque psoriasis during the study period, 
4996 patients met the inclusion criteria and had 12 
months of follow-up 

• At baseline, the mean (SD) age was 51.6 (13.7) years, 
50.5% were male, and 66.4% were white (Table 1) 

• All US geographic regions were represented: 41.4% 
were from the South, 21.6% from the West, 20.7%  
from the Midwest, and 16.1% from the Northeast  
regions (Table 1)