Improvements in psoriasis within different body regions vary over time following treatment with ixekizumab

Abstract

Background: Ixekizumab is a high-affinity monoclonal antibody that selectively targets interleukin-17 A.

Objective: Examine the efficacy of ixekizumab in clearing psoriasis within different body regions.

Methods: Data from 3 placebo- (PBO) or PBO- and etanercept (ETN)-controlled trials were integrated. Patients with moderate-to-severe psoriasis were randomized to 12 weeks of PBO (UNCOVER-1, -2, -3, N = 792; UNCOVER-2, -3, N = 361), 50 mg ETN twice weekly (N = 740), or 80 mg ixekizumab every 2 (IXE Q2W; N = 1169; N = 736) or 4 weeks (IXE Q4W; N = 1165; N = 733) after a 160-mg starting dose.

Results: Mean percent improvements in regional Psoriasis Area and Severity Index (PASI) were noted at Week 1 and increased through Week 12 in the IXE Q2W (approved dosing regimen) group for each body region. Week 12 improvements were 91.4% (head/neck); 92.8% (trunk); 89.9% (arms); and 88.7% (legs) (all regions p < .001 vs. PBO). Mean regional PASI improvements at Week 12 were ≥84.2% for ixekizumab versus ≤70.9% for ETN in all regions (p < .001). Scaling and thickness reduced faster than erythema.

Conclusions: Within 12 weeks of ixekizumab treatment, all signs of psoriasis across all body regions reached clinically meaningful improvements, with the head/neck and trunk responding quicker than psoriasis of the arms and legs, especially with reduced scaling and thickness.

Keywords:

• Psoriasis
• UNCOVER
• ixekizumab
• interleukin-17A
• body region

Acknowledgements

All authors participated in the interpretation of study results, and in the drafting, critical revision, and approval of the final version of the manuscript. Talia M. Muram was involved in the study design and Andrew Blauvelt, Talia M. Muram, Kyoungah See, Craig H. Mallinckrodt, Jeffrey J. Crowley, and Peter van de Kerkhof, were involved in the data collection and/or analyses. Kyoungah See conducted the statistical analysis and Craig H. Mallinckrodt developed the analysis plan. The authors would also like to thank Missy McKean Matthews of InVentiv Health for her support with the statistical analyses, and Luna Sun of Eli Lilly and Company for her graphical support with the animations. Eli Lilly and Company was involved in the study design, data collection, data analysis, and preparation of the manuscript.

Disclosure statement

Andrew Blauvelt has served as a scientific adviser and/or clinical study investigator for AbbVie, Aclaris, Allergan, Almirall, Amgen, Boehringer Ingelheim, Celgene, Dermavant, Dermira, Eli Lilly and Company, Genentech/Roche, GlaxoSmithKline, Janssen, Leo Pharma, Merck Sharp & Dohme, Novartis, Pfizer, Purdue Pharma, Regeneron, Sandoz, Sanofi Genzyme, Sienna Pharmaceuticals, Sun Pharma, UCB, and Valeant, Vidac, and as a paid speaker for Eli Lilly and Company, Janssen, Regeneron, and Sanofi Genzyme. Talia M. Muram, Kyoungah See, and Craig H. Mallinckrodt are currently employees of Eli Lilly and Company and are stock holders in Eli Lilly and Company. Jeffrey J. Crowley has received honoraria as speaker and/or consultant for Amgen, AbbVie, Celgene, Eli Lilly and Company, Janssen, Novartis, Pfizer, and Regeneron. Bakersfield Dermatology, of which Jeffrey J. Crowley is owner and employee, has received research grant support from Amgen, AbbVie, Celgene, Eli Lilly and Company, Janssen, Novartis, and Pfizer. Peter van de Kerkhof has performed consultancy services and acted as a speaker for Abbott, Almirall, Amgen, Celgene, Centocor, Eli Lilly and Company, Galderma, Janssen Cilag, Leo Pharma, Mitsibishu, Novartis, Pfizer, Philips, Sandoz, and has carried out clinical trials for AbbVie, Amgen, Celgene, Eli Lilly and Company, Janssen Cilag, Pfizer, Philips Lighting, Leo Pharma, and Novartis.

Additional information

Funding

This study was sponsored by Eli Lilly and Company, manufacturer of ixekizumab. Medical writing assistance was provided by Samantha Forster, PhD, CMPP of ProScribe – Envision Pharma Group, and was funded by Eli Lilly and Company. ProScribe’s services complied with international guidelines for Good Publication Practice (GPP3).