Secukinumab May Significantly Reduce Inflammation in Patients With Hidradenitis Suppurativa

Secukinumab (Cosentyx; Novartis) can reduce serum high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) levels in patients with hidradenitis suppurativa (HS), according to the authors of a post-hoc analysis of the SUNSHINE and SURISE trials. The analysis is being presented in a poster at the American Academy of Dermatology (AAD) Annual Meeting in March 2024 in San Diego, California.

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hsCRP and ESR are biomarkers of inflammatory burden associated with HS, a systemic, progressive, and painful inflammatory disease that can significantly reduce quality of life.^1,2

During the SUNSHINE and SUNRISE trials, investigators evaluated the effectiveness of secukinumab for patients with HS, evaluating change in biomarkers from baseline to 16 and 52 weeks compared to placebo. The team also evaluated if baseline biomarker levels impacted clinical outcomes.^1,2

The cohort included 1083 patients with baseline hsCRP data and 1068 with baseline ESR data (majority White and female with a mean age between 34.6-37.6 years). Some patients had Hurley stage II and stage III disease.²

Patients treated with secukinumab noticed improvements in as little as 2 weeks, unlike patients treated with placebo. At 16 weeks, patients with a higher level of baseline systemic inflammation (baseline hsCRP ≥10 mg/L or ESR≥20 mm/h) actually experienced a larger reduction in ESR and hsCRP compared to patients with lower level of baseline systemic inflammation.²

Hurley stage III disease was commonly associated with higher baseline inflammation. Patients with higher baseline inflammation were also less likely to achieve HiSCR response, AN50, a reduction in flares, or improvement in NRS30 response compared to patients with lower hsCRP and ESR levels.¹

Although the magnitude of clinical improvement in ESR and hsCRP was greater for patients with higher baseline inflammation, those with less baseline inflammation still experienced clinical response between weeks 16 and 52, according to the AAD poster authors.¹

“Treatment with secukinumab should be considered early in patients with HS when the inflammatory burden is likely to be lower than in later stages of the disease,” wrote the poster authors.

Overall, the entire cohort experienced a durable reduction in hsCRP and ESR levels at 52 weeks from baseline. Similarly, patients who switched from placebo to treatment had less inflammation from weeks 16 to 52.

Going forward, hsCRP and ESR may have clinical use in evaluating inflammatory burden and can be used to gauge response to treatment among patients with HS. The authors noted that there is work continuing to be done to understand the relationship between hsCRP and ESR on clinical response.

“Monitoring these biomarkers can help assess disease activity and treatment response,” the AAD poster authors wrote.

REFERENCES

1. van Straalen K, Bunick CG, Lobach I, et al. Impact of secukinumab on high-sensitvity C-reactive protein and erythrocyte sedimentation rate: Post hoc analysis of pooled data from the SUNSHINE and SUNRISE Phase 3 randomized trials. Poster ID:49169. American Academy of Dermatology AAD Annual Meeting. March 8-12, 2024. San Diego, California.

2. van Straalen K, Bunick CG, Lobach I, et al. Impact of secukinumab on high-sensitvity C-reactive protein and erythrocyte sedimentation rate: Post hoc analysis of pooled data from the SUNSHINE and SUNRISE Phase 3 randomized trials. Abstract. Accessed on March 8, 2024.