Comparative Efficacy of Secukinumab and Ixekizumab on Clinical and Psychological Outcomes in Psoriasis Patients: A Multicenter Prospective Cohort Study

Background Psoriasis is a chronic inflammatory skin disorder that impacts both physical and psychological health. Secukinumab and ixekizumab, IL‐17A inhibitors, are used for moderate‐to‐severe psoriasis, but their comparative efficacy remains underexplored. Objective This study evaluates the efficacy of secukinumab and ixekizumab in a Chinese cohort, focusing on both clinical and psychological outcomes. Methods A prospective, multicenter, observational study included 176 patients treated with secukinumab and 106 patients treated with ixekizumab. Key clinical and psychological outcomes were measured at baseline and Week 12, including PASI, PGA, DLQI, PtGA, and HADS. HADS included achieving HADS‐A or HADS‐D score of 0 and changes in HADS scores from baseline. Results Secukinumab and ixekizumab achieved comparable efficacy at Week 12 in PASI 75, PASI 90, and PGA 0/1 responses ( p > 0.05). However, secukinumab significantly outperformed ixekizumab in psychological outcomes. A higher proportion of patients with secukinumab achieved HADS‐A = 0 (49% vs. 28%) and HADS‐D = 0 (31% vs. 19%) ( p < 0.05). The least squares (LS) mean changes from baseline in HADS‐A or HADS‐D scores were more pronounced in the secukinumab group. Subgroup analysis showed no significant differences in achieving HADS‐A = 0 or HADS‐D = 0 across clinical characteristics within the secukinumab group. Conclusion Secukinumab and ixekizumab showed similar clinical efficacy in treating moderate‐to‐severe psoriasis, but secukinumab provided superior psychological benefits, particularly in reducing anxiety and depression symptoms. These findings highlight the potential of secukinumab to provide enhanced psychological outcomes.