Journal of Clinical and Aesthetic Dermatology

Plaque-type Psoriasis Supplement 2016

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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S12 SUPPLEMENT TO THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY [JUNE 2016 • VOLUME 9 • NUMBER 6 • SUPPLEMENT 1] Secukinumab in the Treatment of Palmoplantar, Nail, Scalp, and Pustular Psoriasis a April W. Armstrong, MD; b Ron Vender, MD; c Leon Kircik, MD a University of Southern California, Los Angeles, California; b Dermatrials Research Inc. and Venderm Innovations in Psoriasis, Hamilton, Ontario, Canada; c Icahn School of Medicine at Mount Sinai, New York, New York R eferences 1 . Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–516. 2. Chiricozzi A, Suarez-Farinas M, Fuentes-Duculan J, et al. Increased expression of interleukin-17 pathway genes in nonlesional skin of moderate-to-severe psoriasis vulgaris. Br J Dermatol. 2016;174(1):136–145. 3. Kim J, Oh CH, Jeon J, et al. Molecular phenotyping small (Asian) versus large (Western) plaque psoriasis shows c ommon activation of IL-17 pathway genes but different regulatory gene sets. J Invest Dermatol. 2016;136(1):161–172. 4. Suarez-Farinas M, Arbeit R, Jiang W, et al. Suppression of molecular inflammatory pathways by Toll-like receptor 7, 8, and 9 antagonists in a model of IL-23-induced skin inflammation. PLoS One. 2013;8(12):e84634. 5. Wang CQ, Suarez-Farinas M, Nograles KE, et al. IL-17 induces inflammation-associated gene products in blood monocytes, and treatment with ixekizumab reduces their expression in psoriasis patient blood. J Invest Dermatol. 2014;134(12):2990–2993. 6. Langley RG, Elewski BE, Lebwohl M, et al. Secukinumab in plaque psoriasis—results of two Phase 3 trials. N Engl J Med. 2 014;371(4):326–338. 7. McInnes IB, Sieper J, Braun J, et al. Efficacy and safety of secukinumab, a fully human anti-interleukin-17A monoclonal antibody, in patients with moderate-to-severe psoriatic arthritis: a 24-week, randomised, double-blind, placebo- controlled, phase II proof-of-concept trial. Ann Rheum Dis. 2014;73(2):349–356. 8. Papp KA, Langley RG, Sigurgeirsson B, et al. Efficacy and safety of secukinumab in the treatment of moderate-to-severe p laque psoriasis: a randomized, double-blind, placebo- controlled phase IIÏ dose-ranging study. Br J Dermatol. 2013;168(2):412–421. 9. Rich P, Sigurgeirsson B, Thaci D, et al. Secukinumab induction and maintenance therapy in moderate-to-severe plaque psoriasis: a randomized, double-blind, placebo-controlled, phase II regimen-finding study. Br J Dermatol. 2013;168(2):402–411. 10. Thaci D, Blauvelt A, Reich K, et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. J Am Acad Dermatol. 2015;73(3):400–409. Introduction Interleukin (IL)-17A is a key molecule in the T helper (Th) 17 pathway, and it plays a critical role in the pathogenesis of psoriasis as well as a number of other immune-mediated diseases, such as psoriatic arthritis, rheumatoid arthritis, and ankylosing spondylitis. 1,2 Secukinumab is a human monoclonal immunoglobulin G (IgG) antibody that blocks the IL-17A ligand. In Phase 2 and 3 studies, secukinumab has been shown to be highly efficacious in treating moderate-to-severe psoriasis, with early onset action, sustained effect, and an acceptable safety profile. 3–5 It is critically important to investigate the role of secukinumab in the treatment of specialized regions of the body and in other psoriasis phenotypes. In this article, the authors examine the clinical evidence for secukinumab in the treatment of palmoplantar, nail, scalp, and pustular psoriasis. Palmoplantar Psoriasis Palmoplantar psoriasis is plaque psoriasis involving the palms and soles. Studies have show that up to 40 percent of patients with plaque psoriasis have some form of palmoplantar involvement. 6 Palmoplantar psoriasis is

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