Secukinumab (Cosentyx®) is an IL-17A antibody approved by the EMA for treatment of psoriasis. Patients treated with secukinumab display improvement in clinical symptoms as measured by PASI90 in up to 80% of the cases from week 16 on. However, it remains unclear which factors contribute to treatment outcome and whether predictive biomarkers can be identified. Thus, we aimed to quantify antimicrobial peptides (AMP) concentrations on the skin in response to secukinumab treatment, as well as to analyze the co-localized microbiome. 40 Patients with moderate to severe psoriasis and an indication for sekucinumab treatment were enrolled in a clinical study and monitored at predefined time points (EudraCT 2015-002588-40). Skin swabs and skin rinsing samples were collected from lesional and non-lesional sites at four time points (at week 0, 2, 16, 24). AMPs isolated from skin rinsing samples were quantified by ELISA and results clustered based on body site. We found that RNase7, hBD2 and psoriasin were highly upregulated in lesional skin as compared to non-lesional skin. Upon treatment, RNase7 levels in lesional skin changed significantly within 16 weeks after first dose. While hBD2 displayed significant reduction as early as at week 2, psoriasin showed a tendency towards site dependent early response. All AMPs measured in lesional sites reached similar concentrations by week 16 as measured in non-lesional skin. Analysis of alpha diversity by Chao index or Shannon index displayed minor tendencies. Correlation of baseline values with PASI or treatment efficacy showed minor tendencies.

ESDRLB014 - Antimicrobial peptide concentration and microbiome diversity in skin of psoriasis patients treated with secukinumab

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING