Secukinumab Cuts Chronic Pain in Hidradenitis Suppurativa
Compared with placebo, secukinumab demonstrated superior pain reduction in moderate to severe hidradenitis suppurativa in two phase 3 trials. Improvements in pain were sustained through week 52 and were associated with better quality of life outcomes.
METHODOLOGY:
Researchers analysed 1084 patients with moderate to severe hidradenitis suppurativa from two phase 3 trials (SUNSHINE and SUNRISE) and randomly assigned them to receive secukinumab 300 mg subcutaneously every 2 weeks (SECQ2W) or every 4 weeks (SECQ4W) or placebo until week 16.
At week 16, patients randomly assigned to receive placebo switched to receive SECQ2W (placebo-SECQ2W) or SECQ4W (placebo-SECQ4W) until week 52, whereas those originally randomly assigned to receive SECQ2W or SECQ4W continued this treatment until week 52.
Pain was assessed using the Patient's Global Assessment of Skin Pain on a continuous numeric rating scale (NRS) through week 52; the severity of pain was categorised into quartiles on the basis of baseline scores (NRS ≤ 3.3, NRS > 3.3 to ≤ 5.4, NRS > 5.4 to ≤ 7.2, and NRS > 7.2).
This post hoc analysis of pooled data from the two trials evaluated the effect of secukinumab on multiple aspects of pain and in different subgroups of patients with hidradenitis suppurativa.
TAKEAWAY:
At week 16, a greater mean absolute change from baseline in skin pain was observed with secukinumab treatment (SECQ2W: mean difference, −1.35; SECQ4W: mean difference, −1.05) than with placebo (mean difference, −0.47).
Reductions in skin pain in the secukinumab groups at week 16 were sustained, with a trend for improvement through week 52. Similar improvements were observed in placebo-SECQ2W and placebo-SECQ4W groups.
Among patients with severe baseline pain (NRS > 7.2), 20.0% in the SECQ2W group and 12.7% in the SECQ4W group achieved significant pain reduction (NRS ≤ 3.3) at week 16.
Patients achieving lower pain scores (NRS ≤ 3.3) experienced better quality of life outcomes.
In the secukinumab groups, the proportion of patients requiring pain medication decreased at weeks 16 and 52 compared with baseline.
IN PRACTICE:
"This post hoc analysis of the SUNSHINE and SUNRISE phase 3 trials highlights the benefits of secukinumab in reducing skin pain in patients with moderate to severe HS [hidradenitis suppurativa], seen within a few weeks of treatment initiation, and sustained, with a trend for improvement, through week 52," the authors wrote. "Importantly, improvements in disease-related pain were associated with improvements in QoL [quality of life] of patients, as well as a decrease in the proportion of patients taking pain medication," they added.
SOURCE:
This study was led by John R. Ingram, Department of Dermatology & Academic Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, Wales. It was published online on May 15, 2025, in Dermatology and Therapy .
LIMITATIONS:
Changes in skin pain observed may have been influenced by the use of concomitant medications and cannot be fully attributed to the study treatment alone. The cutoffs used for assessing skin pain categories were based on baseline NRS quartiles due to the absence of validated cutoffs for the hidradenitis suppurativa population. Additionally, the study population predominantly consisted of self-reported White participants, with a relatively low proportion of Black patients potentially limiting the generalisability of the findings to the broader global population.
DISCLOSURES:
This study was funded by Novartis Pharma AG, Basel, Switzerland. One author declared being an employee and stockholder at Novartis Ireland Limited, Dublin, Ireland. Four authors declared being employees of Novartis Pharma AG, Basel, Switzerland. One author declared being an employee of Novartis Pharmaceuticals, East Hanover, New Jersey, United States, at the time of the study. Several authors reported receiving consulting fees and having other ties with various sources.
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