title: Secukinumab shows significant efficacy in palmoplantar psoriasis: Results from GESTURE, a randomized controlled trial.
abstract: BACKGROUND
  Plaque psoriasis affecting palms and soles is disabling and often resistant to treatment.
  
  
  OBJECTIVE
  Evaluate the efficacy and safety of secukinumab, an anti-interleukin 17A antibody, in subjects with palmoplantar psoriasis.
  
  
  METHODS
  In this double-blinded, randomized controlled trial, 205 subjects were randomized 1:1:1 to secukinumab 300 mg, 150 mg, or placebo. The primary endpoint was Palmoplantar Investigator's Global Assessment (ppIGA) 0 (clear) or 1 (almost clear/minimal) response at week 16.
  
  
  RESULTS
  At week 16, the percentage of subjects who achieved clear or almost clear palms and soles (or ppIGA 0/1) with secukinumab 300 mg (33.3%) and 150 mg (22.1%) was superior to the percentage achieved with placebo (1.5%, P < .001). Palmoplantar Psoriasis Area and Severity Index (ppPASI) was significantly reduced with secukinumab 300 mg (-54.5%) and 150 mg (-35.3%) compared with placebo (-4.0%, P < .001). Dermatology Life Quality Index (DLQI) 0/1 responses from subjects in the secukinumab groups were also significantly higher compared with placebo at week 16 (P < .01) and pain and function of palms and soles was markedly improved with secukinumab as measured by the palmoplantar Quality-of-Life Instrument. Secukinumab 300 mg consistently showed the best outcomes. The safety profile was favorable and similar to previous studies.
  
  
  CONCLUSIONS
  Lack of active comparator.
  
  
  CONCLUSIONS
  In GESTURE, the largest randomized controlled trial in palmoplantar psoriasis, secukinumab demonstrated the greatest efficacy to date for treating difficult-to-treat psoriasis.
authors.affiliation: Department of Dermatology, New York Medical College, Valhalla, New York. Electronic address: alice.gottlieb@gmail.com.
authors.forename: Alice
authors.initials: A
authors.lastname: Gottlieb
authors.affiliation: Holdsworth House Medical Practice, Darlinghurst, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Sullivan
authors.affiliation: Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: van Doorn
authors.affiliation: State Scientific Center of Dermatology, Venereology and Cosmetology, Moscow, Russia.
authors.forename: Alexey
authors.initials: A
authors.lastname: Kubanov
authors.affiliation: Beijing Novartis Pharma Co. Ltd, Shanghai, China.
authors.forename: Ruquan
authors.initials: R
authors.lastname: You
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
authors.forename: Anne
authors.initials: A
authors.lastname: Parneix
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hugot
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Marina
authors.initials: M
authors.lastname: Milutinovic
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy*; D006229:Hand Dermatoses / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; C555450:secukinumab
keywords: clear or almost clear skin; clinical trial; palmoplantar psoriasis; quality of life; secukinumab; superiority