Early intervention with secukinumab prevents epigenetic scar development in new-onset psoriasis: STEPIn mechanistic substudy results.

In 30 seconds

This randomized controlled trial investigated the effects of early secukinumab intervention on psoriatic skin lesions in new-onset patients. Results indicated that early treatment prevents the development of epigenetic scars associated with long-standing psoriasis, as evidenced by persistent CpG methylation changes in the latter group despite clinical improvement.

Key findings

• Gene expression normalized faster in new-onset psoriasis compared to long-standing cases.
• Disease-associated CpG methylation persisted in long-standing psoriasis despite treatment.
• Baseline methylation differences were enriched for AP-1 transcription factor binding sites in long-standing disease.
• Persistent methylation changes mapped to genes involved in small GTPase pathways.

Why it matters

Understanding the molecular differences in psoriasis can help clinicians appreciate the potential for early intervention to alter disease progression and prevent long-term complications associated with chronic inflammation.