12 Dicembre 2022
Alpalhão M, Duarte J, Diogo R, et al.

Lower limbs are the most difficult-to-treat body region of patients with psoriasis: pooled analysis of CLEAR and CLARITY studies of secukinumab versus ustekinumab by body region

BioDrugs 2022;36_781-789
  • Il presente studio ha valutato la risposta al trattamento negli arti inferiori rispetto alle altre aree corporee nei pazienti con psoriasi moderata-severa in terapia con secukinumab e ustekinumab in base ai dati aggregati dei trial CLEAR e CLARITY.
  • Gli arti inferiori sono risultati essere le aree con il coinvolgimento più severo e quelle più difficili da trattare. Secukinumab ha determinato una risoluzione delle lesioni più rapida e maggiore rispetto a ustekinumab in tutte le aree.



The impact of psoriasis, response to treatment, and patients’ perceptions of treatment satisfaction vary by body area.


We aimed to evaluate the level of response in lower limbs versus other body regions in patient with moderate to severe psoriasis treated with secukinumab and ustekinumab.


Data were pooled from CLEAR and CLARITY trials, which included patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] score of ≥12) aged ≥18 years and a diagnosis of ≥6 months before randomisation. Patients received either secukinumab 300 mg or ustekinumab 45/90 mg. The PASI 100 responders and mean PASI scores at weeks 4, 12, 16, 28, 40 and 52 in the head and neck, trunk, upper limbs and lower limbs were measured.


At baseline, analysis of PASI scores for each body region revealed that the lower limbs were the most severely affected body region in both treatment arms (mean PASI scores: secukinumab 24.0; ustekinumab 24.4). For both drugs, the highest clearance rates at week 52 were achieved in the trunk (secukinumab 85.2% vs ustekinumab 68.7%) and head and neck (80.7% vs 68.9%), followed by the upper limbs (72.6% vs 61.9%) and lower limbs (68.1% vs 57.2%). At week 52, the mean PASI score was higher in the lower limbs in both treatment arms versus other body regions.

Conclusions and perspectives

Lower limbs were the most severely affected and most difficult-to-treat regions in patients with psoriasis. Consistent with the individual results of both studies, secukinumab demonstrated numerically faster and higher skin clearance than ustekinumab in all body regions.

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