1
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Bergqvist C. Is there room for another anti-interleukin-17 treatment in the crowded psoriasis therapeutic landscape? Br J Dermatol 2024; 190:e62-e63. [PMID: 37823402 DOI: 10.1093/bjd/ljad383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
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2
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Reich A, Reed C, Schuster C, Robert C, Treuer T, Lubrano E. Real-world evidence for ixekizumab in the treatment of psoriasis and psoriatic arthritis: literature review 2016-2021. J DERMATOL TREAT 2023; 34:2160196. [PMID: 36629859 DOI: 10.1080/09546634.2022.2160196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To describe the results of a structured literature review of real-world outcomes with ixekizumab in patients with psoriasis (PsO) and/or psoriatic arthritis (PsA). METHODS Literature databases, conference proceedings and additional sources were searched for relevant publications. Real-world studies of ≥25 ixekizumab-treated patients with PsO and/or PsA were included. Data on clinical effectiveness, treatment persistence/patterns, economic outcomes, patient-reported outcomes (PROs) and safety were extracted. RESULTS Fifty-one publications were included. Most studies focused on patients with PsO, and the number of publications with a focus on PROs was low. Studies of treatment patterns found that in general, ixekizumab had similar or better persistence versus other biologics, and rates or risk of switching similar to or less than comparator drugs. Adherence to ixekizumab was high, and patients were less likely to discontinue ixekizumab than other biologics. Ixekizumab was effective in the real world, with a safety profile consistent with that reported in clinical trials. CONCLUSIONS Real-world use of ixekizumab in PsO and PsA is effective and safe, with generally high treatment persistence and adherence. Further work is required to determine the impact of ixekizumab on PROs in PsO, and to gather more data on real-world use of ixekizumab in PsA.
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Affiliation(s)
- Adam Reich
- Department of Dermatology, University of Rzeszów, Rzeszów, Poland
| | | | | | | | | | - Ennio Lubrano
- Internal Medicine and Rheumatology Unit, University of Molise, Campobasso, Italy
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3
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Loft N, Egeberg A, Isufi D, Rasmussen MK, Bryld LE, Dam TN, Ajgeiy KK, Bertelsen T, Skov L. Response to Interleukin-17A Inhibitors According to Prior Biologic Exposures: A Danish Nationwide Study. Acta Derm Venereol 2023; 103:adv12616. [PMID: 37987625 PMCID: PMC10680979 DOI: 10.2340/actadv.v103.12616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023] Open
Abstract
Whether response to an interleukin (IL-17) inhibitor is different in patients with previous exposure to an IL-17 inhibitor compared with patients with exposure to biologics with other cytokine targets remains to be elucidated. Therefore, the aim of this study was to assess whether previous exposure to an IL-17A inhibitor was associated with worse response than exposure to (an)other biologic(s). All patients in the DERMBIO register treated with an IL-17A inhibitor (secukinumab or ixekizumab) were included. With an absolute Psoriasis Area and Severity Index (PASI) ≤ 2 as response, the proportion of responders treated with IL-17A inhibitors was assessed in patients previously treated with another IL-17A inhibitor and compared with patients with previous exposure to (an)other biologic(s), using a χ2 test. In total, 100, 93 and 83 patients with previous exposure to an IL-17A inhibitor and 414, 372 and 314 patients with previous exposure to (an) other biologic(s) were assessed after 3, 6 and 12 months, respectively. No differences in the proportion of patients achieving PASI ≤ 2 were observed between the 2 groups after 3 months (54% vs 57%, p = 0.59), 6months (70% vs 66%, p = 0.42) and 12 months (69% vs 60%, p = 0.14). In conclusion, when treating patients with IL-17A inhibitors the cytokine target of the previous biologic does not appear to affect the response.
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Affiliation(s)
- Nikolai Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Daniel Isufi
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Mads K Rasmussen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars E Bryld
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Tomas N Dam
- Dermatology Clinic, Nykoebing Falster, Denmark
| | - Kawa K Ajgeiy
- Department of Dermatology, Odense University Hospital, Odense, Denmark
| | - Trine Bertelsen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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4
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Sotiriou E, Bakirtzi K, Papadimitriou I, Tsentemeidou A, Kougkas N, Panagopoulou A, Ioannides D, Vakirlis E. Real-life intraclass switch among IL-17 inhibitors in psoriasis: Results from a single-centre, 24-week, retrospective study. J Eur Acad Dermatol Venereol 2022; 36:e952-e953. [PMID: 35770467 DOI: 10.1111/jdv.18381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E Sotiriou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - K Bakirtzi
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - I Papadimitriou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - A Tsentemeidou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - N Kougkas
- Fourth Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Panagopoulou
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Greece
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Carrascosa J, Puig L, Belinchón Romero I, Salgado-Boquete L, del Alcázar E, Andrés Lencina J, Moreno D, de la Cueva P. [Translated article] Practical Update of the Recommendations Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPs) on the Treatment of Psoriasis with Biologic Therapy. Part 1. Concepts and General Management of Psoriasis With Biologic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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6
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Carrascosa JM, Puig L, Belinchón Romero I, Salgado-Boquete L, Del Alcázar E, Andrés Lencina JJ, Moreno D, de la Cueva P. Practical update of the Recommendations Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPS) on the Treatment of Psoriasis with Biologic Therapy. Part 1. Concepts and General Management of Psoriasis with Biologic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:261-277. [PMID: 35526919 DOI: 10.1016/j.ad.2021.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A new, updated AEDV Psoriasis Group consensus document on the treatment of moderate to severe psoriasis was needed owing to the approval, in recent years, of a large number of new drugs and changes in the treatment paradigm. METHODOLOGY The consensus document was developed using the nominal group technique and a scoping review. First, a designated coordinator selected a group of Psoriasis Group members for the panel. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. Based on these reviews, the coordinator drew up a set of proposed recommendations, which were then discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. RESULTS The present guidelines include general principles for the treatment of patients with moderate to severe psoriasis and also define treatment goals and criteria for the indication of biologic therapy and the selection of initial and subsequent therapies. Practical issues, such as treatment failure and maintenance of response, are also addressed.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España.
| | - L Puig
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Belinchón Romero
- Departamento de Dermatología, Hospital General Universitario de Alicante-ISABIAL, Universidad Miguel Hernández de Elche, Alicante, España
| | - L Salgado-Boquete
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - E Del Alcázar
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España
| | - J J Andrés Lencina
- Servicio de Dermatología, Hospital Universitario Vega Baja, Alicante, España
| | - D Moreno
- Departamento de Dermatología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, España
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7
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Barešić M, Smiljanić Tomičević L, Anić B, Mayer M. Successful IL-17A inhibitor cycling in psoriatic arthritis patient: a case report and a literature review. Rheumatol Int 2022. [PMID: 35022831 DOI: 10.1007/s00296-021-05065-1/tables/1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Psoriatic arthritis is an inflammatory arthritis with heterogeneous disease presentation. The most affected clinical domain of the disease determines the therapeutic approach. We report the case of a 34-year-old man with all six crucial domains of psoriatic arthritis (psoriasis, peripheral arthritis, axial skeletal manifestations, dactylitis, nail changes, and enthesitis) treated unsuccessfully with conventional synthetic DMARDs, NSAID's, and steroids as well as topical treatment and phototherapy. With golimumab as the first line of bDMARD partial remission was achieved. After 24 months the treatment was switched to secukinumab due to secondary inefficacy. The psoriasis and psoriatic arthritis relapsed after 21 months of treatment with secukinumab. The patient was cycled to ixekizumab with an excellent result. IL-17A inhibitor cycling may be a successful treatment option in some difficult to treat psoriatic arthritis patients.
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Affiliation(s)
- Marko Barešić
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Ljiljana Smiljanić Tomičević
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
| | - Branimir Anić
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
| | - Miroslav Mayer
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
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8
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Successful IL-17A inhibitor cycling in psoriatic arthritis patient: a case report and a literature review. Rheumatol Int 2022; 42:365-370. [PMID: 35022831 DOI: 10.1007/s00296-021-05065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
Psoriatic arthritis is an inflammatory arthritis with heterogeneous disease presentation. The most affected clinical domain of the disease determines the therapeutic approach. We report the case of a 34-year-old man with all six crucial domains of psoriatic arthritis (psoriasis, peripheral arthritis, axial skeletal manifestations, dactylitis, nail changes, and enthesitis) treated unsuccessfully with conventional synthetic DMARDs, NSAID's, and steroids as well as topical treatment and phototherapy. With golimumab as the first line of bDMARD partial remission was achieved. After 24 months the treatment was switched to secukinumab due to secondary inefficacy. The psoriasis and psoriatic arthritis relapsed after 21 months of treatment with secukinumab. The patient was cycled to ixekizumab with an excellent result. IL-17A inhibitor cycling may be a successful treatment option in some difficult to treat psoriatic arthritis patients.
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9
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Berman J, Furer V, Berman M, Isakov O, Zisman D, Haddad A, Elkayam O. Treatment with Ixekizumab Following Secukinumab Failure in Patients with Psoriatic Arthritis: Real-Life Experience from a Resistant Population. Biologics 2021; 15:463-470. [PMID: 34819720 PMCID: PMC8608411 DOI: 10.2147/btt.s326792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022]
Abstract
Objective To assess the clinical response to ixekizumab following secukinumab failure in patients with psoriatic arthritis. Methods A retrospective multi-center observational study included psoriatic arthritis (PsA) patients with a history of treatment with secukinumab, further treated with ixekizumab. Primary endpoint was primary response to treatment (drug survival > 6 months); secondary endpoints were changes in disease activity indices from initiation of ixekizumab to 6 and 12 months later and overall drug survival. Results Of 23 PsA patients, 86% (n = 20) received more than two TNF inhibitors (TNFi). Median secukinumab treatment time was 15 months (IQR 10–21.5 months). Subsequently, 19 patients (83%) had a primary response to ixekizumab. Overall treatment duration during follow-up period for primary responders was 14 months (IQR 10–20.5). Reasons for ixekizumab cessation were worsening psoriasis (27%), peripheral arthritis (27%), both (47%), worsening of axial disease (13%), and adverse events (6%). Articular disease indices including Disease Activity Index for Psoriatic Arthritis (DAPSA), tender joints count (TJC) and Simplified Disease Activity Index (SDAI) were significantly lower at 6 and 12 months (DAPSA 1.5–2 levels reduction; p = 0.018 and 1–1.5 levels reduction; p = 0.031, respectively; TJC −2.16 [−4.0, −0.3]; p = 0.025 and −1.69 [−3.09, −0.28]; p = 0.022, respectively; SDAI −10.13 [−16.4, −3.8], p = 0.003 and −12.2 [−17.1, −7.2], p = 0.0002, respectively). PASI75 at 6 and 12 months was achieved by 63% and 57%, respectively, and PASI100 at 6 and 12 months by 31% and 21%, respectively. Conclusion Patients with resistant PsA, including inadequate response to secukinumab, demonstrated a good response to ixekizumab, albeit limited on time. Within class switch from secukinumab to ixekizumab may be a plausible therapeutic option in PsA patients following secukinumab failure.
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Affiliation(s)
- Julia Berman
- Department of Medicine 'T', Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Victoria Furer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Rheumatology, Sourasky Medical Center, Tel Aviv, Israel
| | - Mark Berman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Rheumatology, Sourasky Medical Center, Tel Aviv, Israel
| | - Ofer Isakov
- Department of Medicine 'T', Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Devy Zisman
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine,Technion, Haifa, Israel
| | - Amir Haddad
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Ori Elkayam
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Rheumatology, Sourasky Medical Center, Tel Aviv, Israel
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10
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Caron B, Jouzeau JY, Miossec P, Petitpain N, Gillet P, Netter P, Peyrin-Biroulet L. Gastroenterological safety of IL-17 inhibitors: a systematic literature review. Expert Opin Drug Saf 2021; 21:223-239. [PMID: 34304684 DOI: 10.1080/14740338.2021.1960981] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Interleukin 17 is a proinflammatory cytokine considered to play a significant role in the immunopathogenesis of many chronic immune-mediated disorders. Interleukin 17 inhibitors provide an excellent treatment option for patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis. However, Interleukin 17 inhibitors have been suspected of worsening or triggering new-onset inflammatory bowel disease. AREAS COVERED A literature search was conducted until March 2021 to investigate reporting prevalence, and characteristics of all gastroenterological adverse events in patients treated with Interleukin 17 inhibitors. One hundred and six clinical randomized trials were included, involving 40,053 patients. Inflammatory bowel disease cases were reported in 0.4% of patients exposed to Interleukin 17 inhibitors. The most frequent other gastrointestinal adverse events were diarrhea (2.5%), nausea or vomiting (0.7%), and gastroenteritis (0.2%). Sixty-one uncontrolled or retrospective studies were included, involving 16,791 patients. Sixty (0.36%) inflammatory bowel disease cases were reported, 0.6% of patients reported other gastrointestinal adverse events. EXPERT OPINION Interleukin 17 inhibitors are safe and effective in the treatment of psoriasis, psoriatic arthritis, and ankylosing spondylitis. Low incidence rate of developing new-onset inflammatory bowel disease or exacerbating preexisting inflammatory bowel disease with anti-IL-17 agents has been reported. Clinicians should be aware of the possibility of these concerns when considering this therapy.
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Affiliation(s)
- Bénédicte Caron
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Jean-Yves Jouzeau
- Department of Clinical Pharmacology and Toxicology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Pierre Miossec
- Department of Clinical Immunology and Rheumatology and the Immunogenomics and Inflammation Research Unit, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Nadine Petitpain
- Department of Clinical Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Pierre Gillet
- Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,Department of Clinical Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Patrick Netter
- Ingénierie Moléculaire et Ingénierie Articulaire (Imopa), UMR-7365, CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
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Goon PKC, Lim HY, Summerfield L, Banfield CC, Sudhoff H, Mallett D. Real-world experience and analyses of the performance of ixekizumab as first-line biologic agent versus second-line (or higher) biologic agent in the treatment of chronic plaque psoriasis. Int J Dermatol 2021; 60:e319-e320. [PMID: 33817799 DOI: 10.1111/ijd.15560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/28/2021] [Accepted: 03/17/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Peter Kin Cho Goon
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | - Hai-Yee Lim
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | - Liz Summerfield
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
| | | | | | - Dick Mallett
- Peterborough City Hospital, North West Anglia Foundation Trust (NWAFT), Peterborough, UK
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Reddy R, Pannu S, Fiumara K, Kahn J, Rosmarin D. Efficacy of in-class interleukin-23 inhibitor switching: risankizumab following guselkumab failure in moderate-to-severe psoriasis treatment. Br J Dermatol 2020; 184:559-561. [PMID: 32998185 DOI: 10.1111/bjd.19575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022]
Affiliation(s)
- R Reddy
- Tufts Medical Center, Boston, MA, USA
| | - S Pannu
- Tufts Medical Center, Boston, MA, USA
| | - K Fiumara
- Tufts Medical Center, Boston, MA, USA
| | - J Kahn
- Tufts Medical Center, Boston, MA, USA
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13
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Grünwald P, Krebs S, Troitzsch P, Roewer J, Emmert S, Thiem A. Etablierung des Schwerpunktes Psoriasis an der Universitätshautklinik Rostock und eine praxisbezogene Übersicht über die Biologikatherapie der Psoriasis. AKTUELLE DERMATOLOGIE 2020. [DOI: 10.1055/a-1147-4666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungDie Diagnostik und Behandlung der Psoriasis stellt einen Schwerpunkt an der Universitätshautklinik Rostock dar. Aufgrund des breiten Spektrums verfügbarer Biologikatherapien für die Behandlung der Psoriasis werden in diesem Artikel praxisbezogene Ratschläge für diese Therapieform gegeben. Dabei wird aufgezeigt, wie das optimale Biologikum für einen individuellen Patienten unter Berücksichtigung möglicher Kontraindikationen, krankheitsspezifischer Aspekte und unerwünschter Wirkungen ausgewählt werden kann. Außerdem wird ein mögliches Vorgehen bei Unterbrechung, Wiederaufnahme oder Umstellung von Biologika erwähnt.
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Affiliation(s)
- P. Grünwald
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Krebs
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - P. Troitzsch
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - J. Roewer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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14
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Loft N, Halling AS, Egeberg A, Skov L. Efficacy of a second interleukin 17 inhibitor in patients with psoriasis: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 84:130-138. [PMID: 32730851 DOI: 10.1016/j.jaad.2020.07.085] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multiple biologics for psoriasis exist, and interleukin (IL) 17 inhibitors are among those with the best efficacy. However, switching treatment is often required at some point, and intraclass switch of IL-17 inhibitors is not well investigated. OBJECTIVES To determine the efficacy of a second IL-17 inhibitor in patients with psoriasis. METHODS Two authors independently searched the databases PubMed and EMBASE for studies reporting on efficacy of IL-17 inhibitors in patients with psoriasis previously exposed to another IL-17 inhibitor. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In total, 14 publications comprising 655 patients were included. The proportion of patients achieving a reduction of 75%, 90%, and 100% in Psoriasis Area Severity Index were, respectively, 74.6 (95% confidence interval [CI], 63.9-84.0), 69.4% (95% CI, 53.2-83.4), and 46.4 (95% CI, 30.5-62.7) after short-term treatment (weeks 9, 12, and 16 combined). LIMITATIONS Most studies included were on ixekizumab and were retrospective chart reviews with no information on the response to the previous IL-17 inhibitor. CONCLUSION Previous treatment with an IL-17 inhibitor does not appear to affect the efficacy of another IL-17 inhibitor in the treatment of psoriasis. However, further prospective studies are needed.
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Affiliation(s)
- Nikolai Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
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Chiricozzi A, Burlando M, Caldarola G, Conti A, Damiani G, De Simone C, Dini V, Malagoli P, Peccerillo F, Potenza C, Scala E, Skroza N, Balato A. Ixekizumab Effectiveness and Safety in the Treatment of Moderate-to-Severe Plaque Psoriasis: A Multicenter, Retrospective Observational Study. Am J Clin Dermatol 2020; 21:441-447. [PMID: 31786732 DOI: 10.1007/s40257-019-00490-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Ixekizumab (anti-IL-17A) is a biological agent used for the treatment of moderate-to-severe psoriasis. Real-life data on the effectiveness and safety of ixekizumab are currently scarce. OBJECTIVE The objective of this study was to evaluate the effectiveness and safety of ixekizumab in a cohort of psoriatic and psoriatic arthritis patients. METHODS We conducted a retrospective study involving 201 patients affected by moderate-to-severe psoriasis and treated with ixekizumab at seven Italian University centers. Data analysis focused on 110 patients who started ixekizumab at baseline and completed at least 24 weeks of treatment. RESULTS Significant reduction of mean (± standard deviation) baseline Psoriasis Area Severity Index (PASI) score (14.3 ± 5.8) was detected at 4 weeks of ixekizumab therapy (4.9 ± 4.2, p < 0.001), with a further significant improvement at weeks 12 and 24 (1.9 ± 2.9 and 0.9 ± 1.6, respectively) (p < 0.001). Our analysis showed 90%, 72%, and 57% of patients achieving PASI 75, 90, and 100 responses (75%, 90%, and 100% reduction in PASI score), respectively, after 24 weeks' therapy. For patients with arthritis (28%), a significant reduction in the mean (± standard deviation) baseline Disease Activity Score (DAS)-28 score (4.6 ± 5.1) was detected at week 4 (2.5 ± 3.9, p < 0.01), with a further significant improvement at weeks 12 and 24 (2.1 ± 1.2 and 1.4 ± 0.9, respectively) (p < 0.001). The bio-naïve group showed significantly higher PASI 90 and 100 response rates at week 12 than the bio-exposed one (p < 0.05). This trend in terms of PASI 100 response was also maintained at week 24 (p < 0.05). Furthermore, PASI 90 responses were significantly higher in anti-interleukin (IL)-17A-naïve patients at week 24 than in anti-IL-17A-experienced ones (p < 0.05). The dropout rate for adverse events (AEs) was as low as 2% (2/110), while AEs that did not cause treatment interruption were observed in 6% (7/110). Patients withdrawing from the study were defined as non-responders according to the non-responder imputation method. The retrospective design of the study does not allow missing data to be retrieved or homogeneous patient selection. CONCLUSIONS The present study illustrates ixekizumab in real-world clinical practice, confirming its usefulness and safety in the management of psoriasis and psoriatic arthritis.
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Tsai YC, Tsai TF. Switching biologics in psoriasis - practical guidance and evidence to support. Expert Rev Clin Pharmacol 2020; 13:493-503. [PMID: 32394765 DOI: 10.1080/17512433.2020.1767590] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Advances of biologic agents have changed the treatment paradigm of psoriasis to higher efficacy and better quality of life. However, the demand for biologic switch is increasing due to patient's greater expectation and decreasing efficacy in long-term use. Also, biologic-induced adverse effects necessitate the switching of biologics. AREAS COVERED This review article was divided into two parts. The first part focused on the biologic switch due to lack of efficacy. The second part provided switching suggestions related to adverse effects. EXPERT COMMENTARY Biologic switch in psoriasis was mainly due to lack of efficacy, and the subsequent biologic agent was usually given at the next scheduled time point without washout period. In pivotal randomized controlled trials, patients with poor response to TNF-alpha inhibitors and ustekinumab achieved better efficacy after switching to IL-23 and IL-17 inhibitors. In addition, real-world data showed that intra-class switch could still achieve a 50%-80% of PASI 75 response in individuals with anti-IL-17 failure histories. As for the biologic switch due to adverse effects, washout period was recommended and transition to a biologic agent with different modes of action was preferred, especially class-specific adverse events.
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Affiliation(s)
- Ya-Chu Tsai
- Department of Dermatology, Far Eastern Memorial Hospital , New Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei, Taiwan
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17
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Kromer C, Wilsmann-Theis D, Gerdes S, Krebs S, Pinter A, Philipp S, Mössner R. Changing within the same class: efficacy of brodalumab in plaque psoriasis after treatment with an IL-17A blocker – a retrospective multicenter study. J DERMATOL TREAT 2020; 32:878-882. [DOI: 10.1080/09546634.2020.1716932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- C. Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | | | - S. Gerdes
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S. Krebs
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A. Pinter
- Department of Dermatology, Venereology, and Allergology, University Hospital, Frankfurt, Frankfurt/Main, Germany
| | - S. Philipp
- Department of Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R. Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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18
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Affiliation(s)
- Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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19
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Conti A, Peccerillo F, Amerio P, Balato A, Bardazzi F, Bianchi L, Burlando M, Cannavò S, Chiricozzi A, Dapavo P, De Simone C, Fargnoli M, Gambardella A, Gisondi P, Malagoli P, Malara G, Mugheddu C, Offidani A, Piaserico S, Prignano F, Stingeni L, Pellacani G. Efficacy and safety of switching to ixekizumab in secukinumab nonresponder patients with psoriasis: results from a multicentre experience. Br J Dermatol 2019; 180:1547-1548. [DOI: 10.1111/bjd.17580] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- A. Conti
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
| | - F. Peccerillo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
| | - P. Amerio
- Department of Medicine and Aging Science Dermatologic Clinic, G. D'Annunzio University Chieti Italy
| | - A. Balato
- Department of Dermatology University of Naples Federico II Naples Italy
| | - F. Bardazzi
- Department of Specialized, Clinical and Experimental Medicine Division of Dermatology University of Bologna Bologna Italy
| | - L. Bianchi
- Department of Dermatology University of Rome Tor Vergata Rome Italy
| | - M. Burlando
- Section of Dermatology University of Genoa San Martino Polyclinic Hospital Genoa Italy
| | - S.P. Cannavò
- Department of Clinical and Experimental Medicine – Dermatology University of Messina Messina Italy
| | - A. Chiricozzi
- Department of Dermatology University of Pisa Pisa Italy
| | - P. Dapavo
- Department of Biomedical Science and Human Oncology Second Dermatologic Clinic University of Turin Turin Italy
| | - C. De Simone
- Department of Dermatology Catholic University of the Sacred Heart Rome Italy
| | - M.C. Fargnoli
- Department of Dermatology University of L'Aquila L'Aquila Italy
| | | | - P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - P. Malagoli
- Dermatology Unit Azienda Ospedaliera San Donato Milanese Milan Italy
| | - G. Malara
- Dermatology Department Grande Ospedale Metropolitano Bianchi Melacrino Morelli 89124 Reggio Calabria Italy
| | - C. Mugheddu
- Department of Medical Sciences and Public Health Section of Dermatology University of Cagliari Cagliari Italy
| | - A.M. Offidani
- Department of Clinical and Molecular Sciences Dermatology Unit Polytechnic Marche University Ancona Italy
| | - S. Piaserico
- Department of Dermatology University of Padua Padova Italy
| | - F. Prignano
- Department of Dermatology University of Florence Firenze Italy
| | - L. Stingeni
- Department of Medicine Section of Clinical, Allergological and Venereological Dermatology University of Perugia Perugia Italy
| | - G. Pellacani
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
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20
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Hegazy S, Konstantinou M, Bulai Livideanu C, Tauber M, Paul C. Efficacy of ixekizumab in patients with resistance or incomplete response to secukinumab. J Eur Acad Dermatol Venereol 2019; 33:e338-e341. [DOI: 10.1111/jdv.15630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Hegazy
- Department of Dermatology Hôpital Larrey Toulouse University Toulouse France
| | - M.P. Konstantinou
- Department of Dermatology Hôpital Larrey Toulouse University Toulouse France
| | - C. Bulai Livideanu
- Department of Dermatology Hôpital Larrey Toulouse University Toulouse France
| | - M. Tauber
- Department of Dermatology Hôpital Larrey Toulouse University Toulouse France
| | - C. Paul
- Department of Dermatology Hôpital Larrey Toulouse University Toulouse France
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Chiricozzi A, Conti A, Burlando M, Odorici G, Gaiani F, Panduri S, Malagoli P. Switching from Secukinumab to Ustekinumab in Psoriasis Patients: Results from a Multicenter Experience. Dermatology 2019; 235:213-218. [DOI: 10.1159/000497274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/25/2019] [Indexed: 11/19/2022] Open
Abstract
Background: Switching between biologics is commonly performed for the management of plaque psoriasis. However, no evidence about switching from secukinumab to ustekinumab has been reported. Methods: This retrospective observational multicenter study aimed to describe efficacy and safety of ustekinumab in secukinumab nonresponder patients. Results: A total of 21 patients unresponsive to secukinumab were treated with ustekinumab for a mean period of 53.3 weeks. Ustekinumab was effective in reducing disease severity, with significant improvements of both psoriasis area severity index (PASI) and dermatology quality of life index (DLQI) scores. PASI score improvements of 31.8, 44, 77.8, 80.3, 80.5, and 89.6%, at week 4, 12, 24, 36, 48, and above 60 weeks, respectively, were detected (p < 0.05), achieving PASI 50, 75, and > 90 responses in 93.8, 87.5, and 50% of patients at week 48. Four patients withdrew from ustekinumab treatment because of inefficacy, and failure of multiple biologic agents (> 2) seemed to affect ustekinumab drug survival. No serious adverse events (AEs) were reported while 38.1% of patients experienced mild AEs. Conclusion: Ustekinumab was safe and effective in treating patients unresponsive to secukinumab.
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