Psoriasis is a chronic inflammatory skin disease affecting nearly 10% of dermatologic patients in Malaysia. Treatment options\ninclude topical agents and phototherapy as well as nonbiologic and biologic systemic therapy.Mild psoriasis can often be managed\nwith topical agents. However, managing moderate to severe psoriasis is more challenging and may require systemic treatment with\nnonbiologics or biologics.Despite the availability of several biologics, there are many unmet clinical needs, whichmay be addressed\nby secukinumab, an IL-17A inhibitor. This position statement is based on an expert panel discussion and is intended to provide\ndermatologists an overview of existing options as well as to provide a better understanding of secukinumab and how it can be\nintegrated into current practice. During the discussion, panelmembers examined current approaches and the role of secukinumab\nin plaque psoriasis management. Panel members estimated that up to 30% of patients have moderate to severe psoriasis but only\n1-2% receive biologics. Highlights from the discussion were that (i) the threshold for biologic use should be lower, in line with\ninternational guidelines; (ii) studies have shown that secukinumab has several advantages over other biologics which are greater\nefficacy, sustained efficacy over time, rapid onset of action, and early evidence of possible disease-modifying potential; and (iii)\nideal candidates for secukinumab are all patients of moderate to severe psoriasis, including those with history of treatment failure,\ndifficult-to-treat patterns of psoriasis (nail, scalp, and palmoplantar psoriasis), psoriatic arthritis, and comorbidities and those\naiming for clear skin. Panel members recommend that secukinumab be considered first line option among biologic therapies.
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