THE DYNAMIC OF SERUM CYTOKINES IN PSORIASIS PATIENTS TREATED WITH SECUKINUMAB

Introduction: Immunological mechanisms of psoriasis have been discussed widely in literature, including cytokines. There are relationships between serum IL-17A, IL-12, and TNF-α with psoriasis, and IL-17A is one of the target cytokines novel biologic therapies. The efficacy, safety, and mechanism of secukinumab were well known while the actual dynamic of circulatory cytokines is less well studied. Objectives: To study the dynamic of serum IL-17A, IL-12, and TNF-α in adult moderate-to-severe plaque psoriasis patients being treated with secukinumab in Ho Chi Minh City Hospital of Dermato-Venereology from July 2019 to May 2020. Subjects and methods: We performed a case series on 35 patients in Ho Chi Minh City Hospital of Dermato-Venereology in the aforementioned period. Results: Despite the patients’ well response to the secukinumab, the concentration of the three cytokines of interest at baseline did not relate to age, sex, age of onset, family history of psoriasis, BMI, metabolic syndrome, history of treatment, or achieving IGA 0/1 at week 12 (p ≥ 0.05). IL-17A and IL-12 correlation at the baseline was statistically significant (p=0.029, r = 0.37). Serum IL-17A and IL-12 were higher at week 12 compared to one at week 4. TNF-α increased at week 12 comparing to one at the baseline. All increases were statistically significant (p<0.05). Conclusion: The paradoxical dynamics of the cytokines while treating psoriasis with secukinumab might potentially cause relapse and/or flare of psoriasis after stop using this agent. Although anti-IL-17A has high efficacy in the treatment of psoriasis, measuring the serum concentration of IL-17A at baseline may not have any essential role in predicting the response of psoriasis to secukinumab.