Association between Secukinumab Treatment and Outcomes in Moderate-to-severe Plaque Psoriasis Patients with Metabolic Syndrome

SHAO Shuyang; TANG Jun

doi:10.11786/sypfbxzz.1674-1293.20260101

Abstract：Objective To evaluate the efficacy of secukinumab in moderate-to-severe plaque psoriasis patients with comorbid metabolic syndrome and to assess the treatment's impact on metabolic parameters.Methods This single-center cohort study enrolled 40 patients with moderate-to-severe plaque psoriasis who were treated at the Provincial Hospital Affiliated to Anhui Medical University from December 2023 to February 2025.Patients were classified as having metabolic syndrome(observation group,n=20)or not(control group,n=20)according to standard diagnostic criteria.All patients received secukinumab 300 mg subcutaneously at weeks 0,1,2,3,4,8,12,and 16.Follow-up visits occurred at weeks 0,4,8,12,and 16,with Psoriasis Area and Severity Index(PASI)scores recorded at each visit.Waist circumference,blood pressure,fasting glucose,triglycerides(TG),and high-density lipoprotein cholesterol(HDL-C)were measured at baseline and immediately prior to the week-16 injection.Outcomes compared between groups included serial PASI scores,achievement rates of PASI 75 and PASI 90,changes in metabolic indicators,and safety/tolerability.Results Both groups experienced significant reductions in PASI scores at weeks 4,8,12,and 16 compared with baseline(all P<0.001).However,at each post-baseline visit the metabolic syndrome group had higher(worse)PASI scores than the control group(P<0.05).The metabolic syndrome group reached PASI 90 later and had lower PASI 75 and PASI 90 response rates than the control group(P<0.05).The overall response rate was 70%in the metabolic syndrome group versus 100%in controls(P<0.05).Subgroup correlation analysis showed a negative association between treatment efficacy and metabolic syndrome presence:moderate psoriasis group r=-0.498(P<0.05)and severe psoriasis group r=-0.623(P<0.01).After 16 weeks,patients with metabolic syndrome showed no significant changes in waist circumference,blood pressure,or fasting glucose,but had a significant reduction in TG(from 2.75±0.83 to 1.75±0.64 mmol/L,P<0.001)and a significant increase in HDL-C(from 0.92±0.14 to 1.36±0.20 mmol/L,P<0.001).The control group showed no significant changes in these metabolic parameters.Safety data were collected throughout the study.Conclusion Secukinumab demonstrated clinical efficacy in moderate-to-severe plaque psoriasis patients both with and without metabolic syndrome;however,the presence of metabolic syndrome was associated with reduced treatment response,with a stronger negative correlation in severe disease.Notably,16 weeks of secukinumab therapy in patients with metabolic syndrome was associated with improved TG and HDL-C levels.