Impact of early treatment of psoriasis on disease recurrence—Results from the STEPIn study

BACKGROUND: Benefits of early intervention with secukinumab in patients with new-onset plaque psoriasis (disease duration: ≤1 year) were investigated in STEPIn study (NCT03020199). OBJECTIVE: To evaluate the proportion of patients maintaining sustained skin clearance in the treatment-free follow-up period up to week (W) 104 following withdrawal of secukinumab and narrow band ultraviolet B at W52. METHODS: Wald test was used for analysis of proportion of patients achieving PASI 90 (key secondary endpoint) from W52 through W104. Missing values were imputed using nonresponder imputation approach. RESULTS: Overall, 93.5% (72/77) of patients completed 52 weeks in the secukinumab arm. At W104, 20.8% of patients who previously received secukinumab sustained PASI 90 responses. At W104, 11.7%, 22.1%, and 24.7% of patients previously treated with secukinumab sustained a PASI 100 response, IGA mod 2011 0/1 and PASI <3. Among secukinumab treated patients, 44% (29/66) who entered the treatment-free follow-up period at W52 did not relapse (loss of 50% of the maximum improvement in PASI following treatment cessation) until W104. LIMITATION: Absence of blinding due to open-label nature of the study. CONCLUSIONS: Early intervention with secukinumab maintains efficacy in a subset of patients with new-onset moderate to severe psoriasis, 1-year following treatment withdrawal.