Comparison of short- and long-term effectiveness of ixekizumab and secukinumab in real-world practice

ABSTRACT

Background: Although secukinumab and ixekizumab both act by inhibiting IL-17A, some scientific evidence suggests that there are differences in efficacy between the two agents.

Objective: The aim of this study was to compare the short- and long-term effectiveness of ixekizumab and secukinumab in clinical practice.

Methods: A retrospective study was conducted on a cohort of 245 psoriatic patients receiving secukinumab or ixekizumab during the period from September 2016 to December 2019. The proportion of patients achieving PASI75, PASI90, and PASI100 at weeks 12 and 24 was calculated. We recorded the 12- and 24-month drug survival as a measure to assess long-term effectiveness.

Results: A higher proportion of patients in the secukinumab group achieved PASI75, 90, and 100 at 12 weeks. The Kaplan-Meier survival curve for any reason of discontinuation showed no differences between the two groups. Instead, the multivariate analysis for ineffectiveness, adjusted for potential confounders, showed a lower drug survival rate in the secukinumab group, with an adjusted HR of 2.57 (95% CI 1.05–6.28, p 0.038).

Conclusion: This real-life study demonstrated that ixekizumab and secukinumab are both highly effective in short- and long-term treatment of psoriasis, even though few differences exist concerning speed of action and long-term effectiveness.

KEYWORDS:

• Psoriasis
• real word
• IL-17A
• secukinumab
• ixekizumab
• drug survival

Article highlights

• Although secukinumab and ixekizumab act by inhibiting the same inflammatory pathway, some evidence suggests that these agents might have different safety and effectiveness profiles in psoriatic patients. However, there is paucity of data regarding a direct comparison between these two anti-IL-17A agents in patients with psoriasis.

• This extensive real-life study showed a very similar efficacy profile of ixekizumab and secukinumab in the short- and long-term treatment of psoriasis.

• Particularly, we observed that secukinumab has a more rapid onset and ixekizumab a longer effectiveness.

Declaration of interest

Giacomo Caldarola reports consulting fees or honorarium and payment for lectures from Lilly and Novartis, outside the submitted work. Clara De Simone reports consulting fees or honorarium from Abbvie, Amgen, Novartis, Celgene, Sanofi, UCB Pharma, Janssen, Lilly and payment for lectures from Abbvie, Lilly, Novartis, UCB Pharma, Celgene, outside the content of this manuscript. Ketty Peris reports Consulting fees or honorarium from Almirall, AbbVie, Biogen, Lilly, Celgene, Galderma, Leo Pharma, Novartis, Pierre Fabre, Sanofi, Sandoz, Sun Pharma and Janssen, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Authors’ contributions

Giacomo Caldarola designed the content of the manuscript and wrote the manuscript; Marco Mariani carried out the statistical analysis; Federico Pirro, Laura Calabrese, Clara De Simone and Ketty Peris acquired data from the literature; Nicola Nicolotti, Martina Burlando and Aurora Parodi contributed to the writing of manuscript; Giacomo Caldarola, Federico Pirro and Laura Calabrese created figures and table and revised language the manuscript. All authors made substantial contributions to the concept and design of the study, revised the manuscript, and gave their approval to the final version of the manuscript.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Reviewer disclosures

One of the reviewers on this manuscript has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Alvotech, Leo Pharma, BMS, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Ortho Dermatology, Abbvie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. They also consult for others through Guidepoint Global, Gerson Lehrman and other consulting organizations. They are a founder and majority owner of www.DrScore.com, and a founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. Two additional peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Supplemental material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper is not funded.