The Role of Secukinumab in the Management of Moderate to Severe Psoroasis: A Systematic Review of Efficacy and Safety
DOI:
https://doi.org/10.37287/ijghr.v8i5.2384Keywords:
biologic agents, IL-17A, psoriasis, secukinumab, systematic reviewAbstract
Psoriasis is a chronic, immune-mediated inflammatory skin disease characterized by erythematous, scaly plaques. In moderate to severe psoriasis, conventional therapies often provide a suboptimal response, making biologic therapies such as secukinumab an important treatment option. Secukinumab is a human IgG1κ monoclonal antibody that targets interleukin-17A (IL-17A). To assess the efficacy and safety of secukinumab in the management of moderate to severe psoriasis. This study is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted through PubMed, Scopus, the Cochrane Library, ScienceDirect, and Google Scholar through April 2026. Included studies were randomized controlled trials (RCTs) evaluating the efficacy and safety of secukinumab in moderate to severe psoriasis. Efficacy outcomes included the Psoriasis Area and Severity Index (PASI), Investigator Global Assessment (IGA), and Dermatology Life Quality Index (DLQI), while safety outcomes included adverse events and serious adverse events. Seven studies met the inclusion criteria. Overall, secukinumab demonstrated high efficacy in improving the clinical manifestations of psoriasis, with better PASI90 and PASI100 scores compared to comparator biologics such as ustekinumab. Secukinumab also provided a rapid clinical response and improved patients' quality of life. The most frequently reported adverse events included nasopharyngitis, upper respiratory tract infection, headache, and injection site reactions, while serious adverse events were reported in low numbers. Secukinumab is an effective and safe biologic therapy for moderate to severe psoriasis.
References
Aboobacker, S., Kurn, H., & Al Aboud, A. M. (2026). Secukinumab. In StatPearls. StatPearls Publishing.
Acer, E., Erdoğan, H. K., Ağaoğlu, E., Baştürk, H., Bilgin, M., & Saraçoğlu, Z. N. (2024). Efficacy and safety of secukinumab in psoriasis: five-year real life experience. Anais brasileiros de dermatologia, 99(6), 840–846.
AlQusaimi, R., AlRujaib, F., AlSharhan, F., AlAwadhi, D., Alassaf, S., & Abdulrahman, F. (2025). Refractory Chronic Plaque Psoriasis and Psoriatic Arthritis Successfully Managed With Combined Secukinumab and Apremilast Therapy: A Case Report. Cureus, 17(11), e96555.
Bagel, J., Blauvelt, A., Nia, J., Hashim, P., Patekar, M., de Vera, A., Hugot, S., & Reich, K. (2020). Secukinumab maintains superiority over ustekinumab in clearing skin and improving quality of life in patients with moderate to severe plaque psoriasis: 52-week results from a double-blind phase 3b trial (CLARITY). Journal of the European Academy of Dermatology and Venereology, 35(1), 135–142.
Bagel, J., Nia, J., Hashim, P. W., Patekar, M., de Vera, A., Hugot, S., & Reich, K. (2018). Secukinumab is superior to ustekinumab in clearing skin in patients with moderate to severe plaque psoriasis (16-week CLARITY results). Dermatology and Therapy, 8(4), 571–579.
Berg, S. H., Balogh, E. A., Ghamrawi, R. I., & Feldman, S. R. (2021). A review of secukinumab in psoriasis treatment. Immunotherapy, 13(3), 201–216.
Blauvelt, A., Armstrong, A. W., Langley, R. G., Gebauer, K., Thaçi, D., Bagel, J., Gordon, K. B., Tyring, S., & Reich, K. (2022). Efficacy of guselkumab versus secukinumab in subpopulations of patients with moderate-to-severe plaque psoriasis: Results from the ECLIPSE study. Journal of Dermatological Treatment, 33(4), 2317–2324.
Blauvelt, A., Pariser, D. M., Tyring, S., Bagel, J., Alexis, A. F., Soung, J., et al. (2023). Psoriasis improvement and inflammatory biomarker normalization with secukinumab: The randomized ObePso-S study. Journal of Dermatological Science, 109(1), 12–21.
Brownstone, N. D., Hong, J., Mosca, M., & Hadeler, E. (2021). Biologic treatments of psoriasis: An update for the clinician. Biologics: Targets & Therapy, 15, 39–51.
Chan, J. J. (2025). Psoriasis: An update on topical and systemic therapies. Australian Prescriber, 48(3), 87–92.
Fargnoli, M. C. (2019). Secukinumab: The anti-IL-17A biologic for the treatment of psoriasis. Case Reports in Dermatology, 11(Suppl. 1), 1–3.
Gao, Y., Xu, T., Wang, Y., Hu, Y., Yin, S., Qin, Z., & Yu, H. (2025). Pathophysiology and Treatment of Psoriasis: From Clinical Practice to Basic Research. Pharmaceutics, 17(1), 56.
Gonçalves, M. B. S., Fonseca, M., Mascarenhas-Melo, F., & Figueiras, A. (2025). Advancing insights into psoriasis: from pathogenesis to current and emerging therapies. International immunopharmacology, 165, 115429.
Jung, S. W., Lim, S. H., Jeon, J. J., Heo, Y. W., Choi, M. S., & Hong, S. P. (2022). Comparison of the efficacy and safety of biologics (secukinumab, ustekinumab, and guselkumab) for the treatment of moderate-to-severe psoriasis: Real-world data from a single Korean center. Biomedicines, 10(5), 1058.
Katsouli, O., Lainis, V., Goules, A. V., & Vlachoyiannopoulos, P. G. (2026). The Pathophysiological Significance of Dual Inhibition of IL-17A and IL-17F in Psoriatic Arthritis and Axial Spondyloarthritis. Mediterranean journal of rheumatology, 37(Suppl 1), 21–36.
Kim, J., Lee, J., Hawkes, J. E., et al. (2023). Secukinumab improves mild-to-moderate psoriasis: A randomized, placebo-controlled exploratory clinical trial. Journal of the American Academy of Dermatology, 88(2), 428–430.
Krueger, J., Langley, R. G., Nigen, S., Kasparek, T., Di Comite, G., Ortmann, C. E., et al. (2023). Secukinumab versus guselkumab in the complete resolution of ustekinumab-resistant psoriatic plaques: The ARROW study. Experimental Dermatology, 32(10), 1834–1847.
Krueger, J. G., Wharton, K. A., Jr., Schlitt, T., Suprun, M., Torene, R. I., Jiang, X., et al. (2019). IL-17A inhibition by secukinumab induces early clinical, histopathologic, and molecular resolution of psoriasis. Journal of Allergy and Clinical Immunology, 144(3), 750–763.
Malagoli, P., Dapavo, P., Amerio, P., Atzori, L., Balato, A., Bardazzi, F., Bianchi, L., Cattaneo, A., Chiricozzi, A., Congedo, M., Fargnoli, M. C., Giofrè, C., Gisondi, P., Guarneri, C., Lembo, S., Loconsole, F., Mazzocchetti, G., Mercuri, S. R., Morrone, P., Offidani, A. M., … Costanzo, A. (2024). Secukinumab in the Treatment of Psoriasis: A Narrative Review on Early Treatment and Real-World Evidence. Dermatology and therapy, 14(10), 2739–2757.
Menter, A., Krueger, G. G., Paek, S. Y., Kivelevitch, D., Adamopoulos, I. E., & Langley, R. G. (2021). Interleukin-17 and Interleukin-23: A Narrative Review of Mechanisms of Action in Psoriasis and Associated Comorbidities. Dermatology and therapy, 11(2), 385–400.
Navarro-Compán, V., Puig, L., Vidal, S., Ramírez, J., Llamas-Velasco, M., Fernández-Carballido, C., Almodóvar, R., Pinto, J. A., Galíndez-Aguirregoikoa, E., Zarco, P., Joven, B., Gratacós, J., Juanola, X., Blanco, R., Arias-Santiago, S., Sanz Sanz, J., Queiro, R., & Cañete, J. D. (2023). The paradigm of IL-23-independent production of IL-17F and IL-17A and their role in chronic inflammatory diseases. Frontiers in immunology, 14, 1191782.
Schwarz, C. W., Skov, L., Egeberg, A., Passey, A., Lee, J., Gorecki, P., & Loft, N. (2024). Characteristics of Patients With Psoriasis Treated With Various Biologics - A Danish Cohort Study. Journal of psoriasis and psoriatic arthritis, 9(2), 51–60.
Thaçi, D., Blauvelt, A., Reich, K., Tsai, T. F., Vanaclocha, F., Kingo, K., et al. (2015). Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. Journal of the American Academy of Dermatology, 73(3), 400–409.
Utama, W. S., Lestari, W., Hajar, S., Sylvawani, M., Ismida, F. D., & Akele, R. Y. (2024). Psoriasis vulgaris patients with psoriatic arthritis managed with interleukin-17A inhibitors: Balancing benefits and adverse effects. Narra J, 4(1), e207.
Zhao, Y., Cai, L., Liu, X. Y., Zhang, H., & Zhang, J. Z. (2021). Efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis: a real-life cohort study. Chinese medical journal, 134(11), 1324–1328.
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