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 and has shown long-lasting efficacy 
and safety in the treatment of the complete spectrum of psoriasis 
manifestations, including nail, scalp, and palmoplantar psoriasis 
and psoriatic arthritis2-8

• There remains limited information on the effectiveness of 
secukinumab treatment in patients with plaque psoriasis in  
US real-world settings 

OBJECTIVE
• To describe real-world effectiveness outcomes in 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 each of the first and second 6 months  
following secukinumab initiation 

Study Variables and Data Analysis 
• Outcomes were assessed in two cohorts: patients who had ≥ 6 

months of follow-up and those who had ≥ 12 months of follow-up

• 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

• Mean (SD) and categorical BSA and Physician Global 
Assessment (PGA) scores were evaluated during the 6-month 
baseline period and at 6-month (window, 5-7 months) and 
12-month (window, 11-13 months) follow-up visits among patients 
with scores reported at baseline and follow-up

• Categorical changes from baseline to 6- and 12-month follow-up 
visits were calculated among patients with both baseline and  
follow-up BSA and PGA measurements available 

Secukinumab Is Associated With Improvements in  
Real-World Effectiveness Outcomes Through 12 Months 
of Follow-Up in Patients With Plaque Psoriasis: Analysis 
of 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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Presented at the 2019 Winter Clinical Dermatology Conference; 
January 18-23, 2019; Koloa, HI.

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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.

RESULTS
Patient Demographics 
• Among all patients who initiated secukinumab with 6 months  

(N = 6568) and 12 months of follow-up (N = 4996), the mean (SD) 
age was 51.1 (13.9) and 51.6 (13.7) years, respectively, 50.6% 
and 50.5% were male, and all US geographic regions were 
represented (Table 1) 

Table 1. Demographics, Clinical Characteristics, and  
Treatment History of Patients With Psoriasis Who  
Initiated Secukinumab and Had 6 Months or 12 Months  
of Follow-Up

Characteristic
Patients With 

6-Month Follow-Up
(N = 6568)

Patients With 
12-Month Follow-Up

(N = 4996)

Age, mean (SD), years 51.1 (13.9) 51.6 (13.7)

Male, n (%) 3326 (50.6) 2524 (50.5)

US region, n (%)

South 2734 (41.6) 2070 (41.4)

West 1428 (21.7) 1080 (21.6)

Midwest 1355 (20.6) 1036 (20.7)

Northeast 1040 (15.8) 802 (16.1)

Unknown 1828 (27.8) 8 (0.2)

Race

White 4270 (65.0) 3317 (66.4)

Black 187 (2.9) 141 (2.8)

Asian 163 (2.5) 129 (2.6)

Hispanic 120 (1.8) 92 (1.8)

Other/unknown 1828 (27.8) 1317 (26.4)

Comorbidities, n (%)

Hypertension 1926 (29.3) 1487 (29.8)

Psoriatic arthritis 1443 (22.0) 1110 (22.2)

Diabetes 1122 (17.1) 877 (17.6)

Hyperlipidemia 953 (14.5) 751 (15.0)

Malignancies 782 (11.9) 633 (12.7)

Coronary heart disease 169 (2.6) 125 (2.5)

Cerebrovascular disease* 80 (1.2) 70 (1.4)

Obesity 65 (1.0) 55 (1.1)

Rheumatoid arthritis 26 (0.4) 24 (0.5)

Treatment history

Prior biologic treatment 
preceding secukinumab 
claim, n (%)

Tumor necrosis  
factor inhibitors† 1469 (54.6) 1148 (54.1)

Ustekinumab 1250 (46.5) 1011 (47.6)

IL-17A inhibitors‡ 103 (3.8) 69 (3.3)

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. 

Change in Clinical Effectiveness Outcomes From 
Secukinumab Initiation 
• Among patients with plaque psoriasis in the MMDS database  

who initiated secukinumab and had baseline BSA and PGA 
values, 792 and 472 patients, respectively, had BSA measurements, 
and 741 and 441 patients, respectively, had PGA scores at  
6 and 12 months

• The mean BSA decreased from 20.1% at baseline to 11.1% at  
6 months and from 21.4% at baseline to 11.4% at 12 months 
(Figure 1A)

 – The proportion of patients who had mild disease (BSA < 3%) 
increased from 10.7% (85 of 792 patients) at baseline to 
38.1% (302 of 792) at 6 months and from 9.8% (46 of 472 
patients) to 37.9% (179 of 472) at 12 months (Figure 1B)

 – The proportion of patients with severe disease (BSA > 10%) 
decreased from 49.6% (393 of 792 patients) at baseline to 
26.5% (210 of 792) and from 51.3% (242 of 472 patients) to 
28.6% (135 of 472) at 12 months

Figure 1. (A) Mean and (B) Categorical BSA* Change in  
Patients Who Initiated Secukinumab and Had 6 Months  
and 12 Months of Follow-Up  

BSA, affected body surface area. 
*  Available effectiveness records for BSA were reported based on the index visit or the visit closest  

to the index with such values during the 6-month baseline period. 
†  Baseline data were from the patients who enrolled and had 6- or 12-month follow-up  

periods, respectively.

Figure 2. (A) Mean and (B) Categorical PGA* Change in  
Patients Who Initiated Secukinumab and Had 6 Months  
and 12 Months of Follow-Up   

PGA, Physician Global Assessment. 
*  Available effectiveness records for PGA scores were reported based on the index visit or the  

visit closest to the index with such values during the 6-month baseline period. 
†  Baseline data were from the patients who enrolled and had 6- or 12-month follow-up  

periods, respectively.

Categorical BSA

A 

B 

20.1
n = 792

11.1
n = 792

21.4
n = 472

11.4
n = 472

0

5

10

15

20

25

30

M
ea

n 
Va

lu
e 

,%

Overall BSA

Baseline† 6-month follow-up 12-month follow-up

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

.0

0

10

20

30

40

50

60

70

80

90

100

Baseline
(n = 792)

6-month
follow-up
(n = 792)

Baseline
(n = 472)

12-month
follow-up
(n = 472)

P
ro

po
rt

io
n 

of
 P

at
ie

nt
s,

 %

10.7
n = 85

38.1
n = 302

9.8
n = 46

37.9
n = 179

39.7
n = 314

35.4
n = 280

39
n = 184

33.5
n = 158

49.6
n = 393

26.5
n = 210

51.3
n = 242

28.6 
n = 135

A 

B 

M
ea

n 
Va

lu
e 

,%

Overall PGA

Baseline† 6-month follow-up 12-month follow-up

Clear/minimal (0–1) Mild/moderate (2–3) Marked/severe (4–5)

P
ro

po
rt

io
n 

of
 P

at
ie

nt
s,

 %

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

14.0
n = 104

46.8
n = 347

14.1
n = 62

39.9
n = 176

60.3
n = 447

45.5
n = 337

58.3
n = 257

49.7
n = 219

25.6
n = 190

7.7
n = 57

27.7
n = 122

10.4 
n = 46

0

10

20

30

40

50

60

70

80

90

100

Baseline
(n = 741)

6-month
follow-up
(n = 741)

Baseline
(n = 441)

12-month
follow-up
(n = 441)

Categorical PGA

2.9
n = 741

1.7
n = 741

2.9
n = 441

2.0
n = 441

• The mean PGA score decreased from 2.9 to 1.7 at 6 months and 
from 2.9 to 2.0 at 12 months (Figure 2A)

• The proportion of patients who achieved a PGA score of 0/1 
(clear/minimal disease) increased from 14.0% (104 of 741 patients) 
at baseline to 46.8% (347 of 741) at 6 months and from 14.1%  
(62 of 441 patients) to 39.9% (176 of 441) at 12 months (Figure 2B)

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

• This study was retrospective in nature and relied on coding to 
make associations between secukinumab exposure and 
effectiveness outcomes

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

psoriasis, secukinumab treatment increased the proportion of 
patients who achieved BSA < 3% and PGA scores of 0-1 by  
3- to 4-fold after 6 months, with similar improvements shown 
through 12 months

• These findings highlight the real-worldeffectiveness of 
secukinumab in improving skin clearance in patients with mostly 
moderate-to-severe disease and are consistent with previous  
real-world studies

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

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

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

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

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

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

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

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

• The most common comorbidities were hypertension, psoriatic 
arthritis, and diabetes (Table 1)

• Overall, in both groups, approximately 40% of patients received 
prior biologic treatment during the 6-month baseline period (Table 1)