Short-term effectiveness of ixekizumab to refractory psoriatic arthritis with spondyloarthritis: two case reports

Abstract

Psoriatic arthritis (PsA) manifests not only skin lesion but also peripheral and axial joint involvements, thus the disease is considered to be part of spondyloarthritis. In patients with active spondyloarthritis, tumour necrosis factor inhibitors biologics are often considered, but there is not sufficient evidence about other type of biologics. Ixekizumab (IXE) is a humanised monoclonal antibody, which acts against interleukin-17A, a cytokine involved in psoriasis pathogenesis. IXE was administered to two patients with refractory PsA, manifested via extended skin lesions and complicated by axial joint involvement. The effectiveness and imaging results during 12 weeks of treatment were assessed. IXE improved disease activity in both a tumour necrosis factor inhibitors biologics-inadequate responder and a bio-naïve patient and, consequently, IXE probably plays a key role in treatment of axial disease of PsA.

Keywords:

• Psoriatic arthritis
• spondyloarthritis
• Ixekizumab
• IL-17 inhibitor
• magnetic resonance imaging

Patient consent

Written consent was obtained from the patient for publication in all of the cases.

Ethical Approval

Not Applicable.

Conflict of interest

Yoshiya Tanaka, has received speaking fees and/or honoraria from Daiichi-Sankyo, Astellas, Eli Lilly, Chugai, Sanofi, Abbvie, Pfizer, YL Biologics, Bristol-Myers, Glaxo-Smithkline, UCB, Mitsubishi-Tanabe, Novartis, Eisai, Takeda, Janssen, Asahi-kasei and has received research grants from Mitsubishi-Tanabe, Bristol-Myers, Eisai, Chugai, Takeda, Abbvie, Astellas, Daiichi-Sankyo, Ono, MSD, Taisho-Toyama. Other authors declared none.