乌鸦传媒

WASHINGTON -- More than half of patients with moderate-to-severe plaque psoriasis remained clear of lesions after a year of treatment with the interleukin-17A inhibitor ixekzumab, according to data reported here.

The 60-week follow-up data showed that 54% of patients treated with either of two doses of ixekizumab had 100% improvement in the Psoriasis Area and Severity Index (PASI 100). More than 70% achieved PASI 90, and more than 80% met criteria for PASI 75 response.

In general, the monoclonal antibody demonstrated good tolerability, associated with a discontinuation rate of about 5%, , of Oregon Medical Research Center in Portland, reported at the American Academy of Dermatology meeting.

"Izekizumab treatment led to high clinical response rates and sustained efficacy in a majority of patients," Blauvelt said. "More than half of ixekizumab-treated patients achieved complete resolution of psoriatic plaques at week 60. The safety profile for ixekizumab was similar to what was observed during the 12-week induction period."

Ixekizumab is a specific inhibitor of the IL-17A receptor. The antibody was compared against placebo and etanercept (Enbrel) in two phase III trials that evaluated two ixekizumab dosing schedules (administration every 2 or 4 weeks). More than 1,200 patients were randomized 1:2:2:2 to placebo, etanercept (Enbrel) or one of the ixekizumab schedules.

As , the antibody demonstrated superior efficacy after a 12-week induction period. PASI 75 response rates were 7.3% with placebo, 53.4% with etanercept, and 84.2% and 87.3% with the two ixekizumab regimens. PASI 90 rates were 3.1%, 25.7%, 65.3%, and 68.1%. PASI 100 responses were attained by 0%, 73%, 35%, and 37.7%.

Upon completion of the induction phase, all patients transitioned to open-label ixekizumab, administered every 4 weeks. Blauvelt reported findings for patients who received only ixekizumab for the entire 60-week follow-up period.

The data showed that response rates attained at 12 weeks with ixekizumab held up through the 60-week follow-up period. The intention-to-treat analysis (n=771) showed response rates of 82%, 72%, and 54% for PASI 75, PASI 90, and PASI 100. A per-protocol analysis (n=722) showed a PASI 75 response rate of 87%, PASI 90 response rate of 77%, and PASI 100 response rate of 57%.

Cosentyx Versus Stelara

In another study reported here, long-term follow-up from a randomized trial comparing two other biologic drugs showed sustained superiority for secukinumab (Cosentyx) over ustekinumab (Stelara) in patients with moderate to severe plaque psoriasis.

The randomized comparison of secukinumab (Cosentyx) and ustekinumab involved almost 700 patients who had a baseline mean PASI score ≥12, an investigator global assessment score ≥3, and body surface area involvement ≥10%. They were randomized to the monclonal antibodies, and the primary endpoint was PASO 90 response at 16 weeks. As , secukinumab resulted in a PASI 90 rate of 80.1% versus 59.0% for ustekinumab (P<0.0001). PASI 100 rates were 45% and 29.2% (P<0.0001).

Follow-up in both groups continued to week 52, during which time patients treated with secukinumab continued to have better psoriasis clearance rates compared with those treated with ustekinumab, said , of the University of Lubeck in Germany. The secukinumab group had a PASI 90 rate of 76.2% compared with 60.6% for the ustekinumab group (P<0.0001). PASI 100 rates (a secondary endpoint) were 45.9% and 35.8% with secukinumab and ustekinumab, respectively (P<0.05).

Investigators in the trial collected quality of life data by means of the Dermatology Qualty of Life Index (DLQI). A secondary endpoint was the proportion of patients with a DLQI score of 0 or 1 at week 52 (responder). Response rates were 71.6% with secukinumab and 59.2% with ustekinumab (P=0.0008). A significant between-group difference emerged at 4 weeks and persisted throughout the 52-week follow-up period, Thaci said.

Secukinumab and ustekinumab had similar and favorable safety profiles. No new or unexpected adverse events or toxicities occurred in either group. No patient developed tuberculosis, Crohn's disease, or ulcerative colitis. The only notable difference was a higher incidence of candida infection with secukinumab (6.4% versus 1.6%). Thaci said none of the infections were serious.