Anti-IL17 blockade leads to maintained pain reduction in patients with HS

A pooled analysis found that secukinumab treatment entailed a numerically greater pain reduction than placebo in patients with hidradenitis suppurativa.

Patient’s Global Assessment: the guiding numeric scale

Dr John Ingram (Cardiff University, UK) presented the post-hoc analysis of the phase 3 SUNSHINE (NCT03713619) and SUNRISE (NCT03713632) trials that focused on pain ameliorations with secukinumab for HS treatment1. Previously, the 2 identical trials had found the superiority of the IL-17A inhibitor over placebo for a bi-weekly dosing (Q2W) with 300 mg at week 16.

Within the 2 trials, pain was measured by the Patient’s Global Assessment (PGA) of skin pain on a numeric rating scale (NRS). The current analysis evaluated changes in skin pain at its worst in different categories of intensity: no pain: NRS 0, mild pain: NRS >0–≤6, moderate pain: NRS >6–≤8, and severe pain: NRS >8.

Over 1,000 participants

SUNSHINE and SUNRISE included over 1,000 participants with a mean age of 36.2 years, 56.3% were women, and the mean baseline pain was NRS 5.2. At week 16, secukinumab numerically decreased pain in comparison to placebo: Q2W NRS -1.4, Q4W NRS -1.1 versus placebo NRS -0.5. These pain ameliorations were continued to week 52, with a numerically greater decrease on secukinumab Q2W (NRS -1.8) than Q4W (NRS -1.5). 

Looking at reductions after 1 year by pain category, 8.3% of the participants on Q2W secukinumab with moderate pain and 8.6% with severe pain at baseline achieved a status of no pain. Also, 63.3% and 45.7% of these groups experienced a reduction to mild pain, respectively. After dichotomising into NRS >6 and NRS≤6, 65.3% (Q2W) and 70.1% (Q4W) of those with moderate/severe pain at baseline had mild/no pain after 52 weeks.

In their conclusion, the authors added that secukinumab treatment also entailed a decreased use of pain medication over time and an improvement in quality of life.

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  1. Ingram JR, et al. Secukinumab provides sustained improvements in pain in patients with moderate to severe hidradenitis suppurativa: A post-hoc analysis of the SUNSHINE and SUNRISE phase 3 trials. P0045, EADV Congress 2023, 11–14 October, Berlin, Germany.