Secukinumab for the treatment of residual psoriasis: a case series

Patients with plaque-type psoriasis persisting in limited and critical areas often require further treatment even after a PASI reduction has been obtained. Due to its alternative mechanism of action, secukinumab may be a therapeutic upgrade for patients who respond to anti-TNF-α drug but have persistent disease in limited and critical areas. This paper describes our experience in patients with residual psoriasis limited to critical areas, after anti-TNF-α treatment, who subsequently received secukinumab. Specifically, before secukinumab, 4 patients were treated with acitretin and 8 patients with cyclosporine followed by adalimumab or etanercept. Eleven of 12 patients achieved PASI 90/100 at week 3/5, retaining the effect for 52 weeks of treatment, with irrelevant residual scalp lesions. The non-responder patient had been treated with cyclosporine. Secukinumab improvement was independent from the previous treatment (acitretin vs cyclosporine or adalimumab vs etanercept). Secukinumab may be effective and safe for the treatment of patients with residual psoriasis that still affects the patient's life.