OBJECTIVES: Little was known about real-world outcomes of secukinumab in psoriasis in Thailand. This study aimed to assess real-world clinical outcomes of secukinumab in Thai patients with psoriasis (PsO), with subgroup analyses by adherence rate and completeness of loading dose.

METHODS: This retrospective chart review study included 163 adult patients with moderate-to-severe plaque PsO from 7 university hospitals between 2017 to 2021. Improvement in the Psoriasis Area and Severity Index (PASI) scores from baseline at 4 and 16 weeks after secukinumab initiation was assessed. Adherence rate was calculated based on recommended total number of injections. Subgroup comparisons were performed with Chi-square or Fisher’s exact test, and the level of significance was set at < 0.05.

RESULTS: The patients’ mean (SD) age was 44.0 (14.0) years. Their median (interquartile range, IQR) PsO duration was 6.1 (10.9) years, with a median (IQR) baseline PASI score of 14.8 (15.2). The PASI score improved from baseline by 60% at week 4 and 100% at week 16. Adherence rates of 100%, 75-99%, 50-74%, and <50% adherence were achieved in 11.7%, 21.5%, 27.6%, and 39.3% of patients, respectively. Those with 100% adherence had the highest PASI 75 (76.9%), PASI 90 (53.9%), and PASI 100 (15.4%) achievements at week 4. Patients with 100% and 75-99% adherence also had greater PASI 75/90/100 achievements at week 16. PASI 75 and PASI 90 achievements at week 4 were significantly higher in a complete loading dose group (P=0.004 and P=0.006). At week 16, PASI 75/90/100 achievements were significantly higher in the complete loading dose group.

CONCLUSIONS: Secukinumab demonstrated good real-world clinical outcomes in Thai moderate-to-severe PsO patients. Higher PASI achievement was revealed among patients who received complete loading dose and those with high adherence rate.