ArticleBioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy2026
Clinical Outcomes After Week-12 Response-Guided Secukinumab Discontinuation in Psoriasis: A Prospective Real-World Cohort Study.
Article in BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundContinuous biologic therapy achieves psoriasis control but may be limited by cost, adherence burden, safety concerns, and patient preference. Evidence on outcomes after early, patient-driven discontinuation of secukinumab in routine practice is limited.
objectiveThe aim of this study was to describe clinical outcomes after voluntary secukinumab discontinuation among patients achieving predefined week-12 response targets and to explore factors associated with relapse.
methodsThis prospective single-center cohort enrolled 172 adults with moderate-to-severe plaque psoriasis initiating secukinumab during 2022-2024. At week 12, patients achieving target response achievement 1 (TRA1: Psoriasis Area and Severity Index [PASI]75, Physician's Global Assessment [PGA] 0/1, or body surface area [BSA] <3%) or nested TRA2 (PASI90, PGA 0/1, or BSA <1%) could discontinue secukinumab under supervision and continue topical therapy. Relapse was defined as loss of PASI75 at weeks 24 or 48.
resultsBy week 12, 82.6% of patients achieved TRA1 and 66.9% achieved TRA2. Relapse at week 24 and week 48 occurred in 35.9% (51/142) and 45.1% (55/122) of TRA1 patients and in 28.7% (33/115) and 36.7% (36/98) of TRA2 patients, respectively. Week-4 PASI75 responders had lower week-48 relapse rates than non-early responders in TRA1 (29.0 vs 50.5%) and TRA2 (27.6 vs 40.6%). Early response was associated with lower relapse odds in TRA1 at week 48 (adjusted OR 0.33; 95% CI 0.12-0.87). Higher BMI was associated with greater relapse risk, whereas smoking and comorbidities were not independently associated with relapse.
conclusionsIn selected patients achieving week-12 response targets and voluntarily discontinuing secukinumab, early response and BMI showed exploratory associations with relapse risk. These findings require validation before informing routine discontinuation decisions.
trial registrationChinese Clinical Trial Registry (ChiCTR2200066894).
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