Secukinumab efficacy in reducing the severity and the psychosocial impact of moderate-to-severe psoriasis as assessed by the Simplified Psoriasis Index: results from the IPSI-PSO study

Abstract

Background: The utility of the Simplified Psoriasis Index (SPI), a recently developed multidomain tool for assessing psoriasis, was investigated in a study assessing response to secukinumab.

Methods: In an open-label, multicentre study involving 17 French centres, patients with moderate-to-severe plaque psoriasis received secukinumab 300 mg subcutaneously once weekly from baseline to W4, then every 4 weeks until W48. Dermatologist-scored SPI psoriasis severity (proSPI-s) was compared with Psoriasis Area and Severity Index (PASI). Patient self-assessed severity (saSPI-s) and psychosocial impact (SPI-p) were compared with PASI and Dermatology Life Quality Index (DLQI), respectively.

Results: We included 120 patients (69.2% male; mean age 45.9 years; mean duration of psoriasis 21.6 years). Mean baseline scores were as follows: proSPI-s 24.9, saSPI-s 23.5, PASI 23.1, SPI-p 8.2 and DLQI 13.6. Severity scores achieved by 16 weeks (proSPI-s 2.3, saSPI-s 2.2 and PASI 2.2) were maintained to W52. Reductions in mean psychosocial impact scores were maintained to W52 (SPI-p and DLQI, respectively, 2.1 and 1.5 at W16; 1.5 and 1.9 at W52).

Conclusions: Decrease of PASI scores in response to secukinumab was closely correlated with proSPI-s, supporting the latter's suitability for assessing response to therapy. Although the correlation between PASI and saSPI-s was slightly weaker, patients were able to complete a valid assessment of their psoriasis independently, and thus potentially remotely. With the added benefit of psychosocial impact assessment (SPI-p), SPI provides a valid tool enabling patients to assess their own psoriasis, remotely if necessary.

Figure 1

Simplified Psoriasis Index (SPI) version for completion by healthcare professionals (proSPI)*. *showing updated English version with modifications to PART 3: the systemic agents to be displayed can be preselected from drop‐down lists to reflect past and current practice in each department before the proformas are printed for distribution; the English language versions of both proSPI and saSPI are freely available for download as supplementary files (https://globalpsoriasisatlas.org/resources).

Figure 2

Changes in mean and median psoriasis severity scores over the course of the study (full analysis set population, N = 119): (a) Psoriasis Area and Severity Index (PASI), (b) professionally assessed Simplified Psoriasis Index (SPI) current severity score (proSPI‐s) and (c) patient self‐assessed SPI current severity score (saSPI‐s). Means are represented by diamonds; medians with interquartile and overall ranges are represented by box and whisker plots.

Figure 3

proSPI‐s scores at Week 0 and Week 16 for each of 10 body sites. Numbers of scores for each extent category: (1) widespread and involving much of the affected area; (0.5) obvious but still leaving plenty of normal skin and (0) clear or minimal with no more than a few scattered thin plaques.

Figure 4

Changes in mean and median psychosocial impact scores over the course of the study (full analysis set population, N = 119): (a) Dermatology Life Quality Index (DLQI) and (b) Simplified Psoriasis Index psychosocial impact score (SPI‐p). Means are represented by diamonds; medians with interquartile, and overall ranges are represented by box and whisker plots.