In total, the HHDV dataset contained 236 records of patients with plaque PsO (Fig. 1). Of these, 230 patients were treated with secukinumab and the PASI score at baseline was available; these 230 patients were included in the intention-to-treat (ITT) population. Among the ITT population, 222 patients completed the 16-week follow-up and were included in the per protocol (PP) population.

Flow chart of patient enrollment. HHDV Ho Chi Minh City Hospital of Dermato-Venereology, N total number of patients, PASI Psoriasis Area and Severity Index

In the ITT population, the majority of patients were men (66.1%), and at baseline the mean age ± standard deviation (SD) was 41.46 ± 14.29 years, mean body mass index (BMI) was 23.47 ± 4.70 kg/m2, and 27% of patients (n = 62) were obese (Table 1). The mean disease duration of patients was 7.91 ± 7.91 years. A total of 30.9% of patients (n = 71) in the ITT population had comorbidities at baseline, of which the most commonly reported were obesity (27.0%), high blood pressure (5.7%), and hepatitis B virus infection (3.5%). Up to 51.3% of patients (n = 118) reported overall nail manifestation (including onycholysis, pitting, subungual hyperkeratosis, and other nail changes), while 7.0% (n = 16) reported concomitant PsA. The majority of the patients were biologic naïve (96.5%). Patient demographics and disease characteristics at baseline are presented in Table 1.

In this study, secukinumab treatment was highly effective in patients with moderate-to-severe PsO as early as 4 weeks following initiation of treatment, and this was sustained up to 16 weeks, as demonstrated by the PASI and DLQI responses. At week 4, 54.6% of patients (n = 124) achieved PASI 75 response compared to none at baseline. By week 16, 81.1, 68.9, and 36.5% of the overall ITT population (n = 180, 153, and 81) achieved PASI 75, 90, and 100, respectively. Improvement in disease activity was complemented by overall improvement seen in QoL assessment, with 66.1% of the overall population (n = 154) reporting DLQI 0/1 score by week 16 (Fig. 2).

Disease activity and quality of life assessment over time in the intention-to-treat study population. DLQI 0/1 Dermatology Life Quality Index score indicating no effect of disease on patient’s life, ITT intention-to-treat, N number of patients, PASI 75, 90, 100 PASI scores indicating 75, 90, and 100% improvement in disease activity from baseline, respectively, QoL quality of life

The aim was to identify the predictors of response by stratifying patients based on obesity status, presence of comorbidities, and presence of PsA. Similar improvement in disease activity and QoL was observed when stratification was applied.

A total of 80.0, 63.3, and 23.3% of patients (n = 48, 38, and 14) with obesity at baseline achieved PASI 75, 90, and 100, respectively, at week 16 (vs. none at baseline). Similarly, for non-obese patients, 81.5, 71.0, and 41.4% (n = 132, 115, and 67) achieved PASI 75, 90, and 100, respectively, at week 16. In addition, 63% of patients (n = 39) with obesity at baseline and 67.7% of non-obese patients (n = 115) achieved DLQI 0/1 by week 16 (Fig. 3a, b).

Clinical activity and QoL assessment of patients over time stratified by obesity status (a, b), presence of comorbid conditions (c, d), and concomitant PsA (e, f). N Number of patients, PsA psoriatic arthritis

When stratified by comorbidity, at week 16, 82.4, 52.9, and 35.3% of patients with a comorbidity (n = 14, 9, and 6) and 81.0, 70.2, and 36.6% of those without comorbidity (n = 166, 144, and 75) achieved PASI 75, 90, and 100, respectively. Similarly, improvement in DLQI was seen in both subgroups of patients (63.2 and 67.3%; n = 13 and 141, respectively) (Fig. 3c, d).

When stratified by concomitant PsA, at week 16, 75.0, 62.5, and 25.0% of patient with concomitant PsA (n = 12, 10, and 4) and 81.6, 69.4, and 37.4% of those without concomitant PsA (n = 168, 143, and 77) achieved PASI 75, 90, and 100, respectively. Similarly, improvement in DLQI was seen in both subgroups of patients (43.8 and 67.8%; n = 8 and 146, respectively) (Fig. 3e, f).