Ixekizumab treatment in patients with moderate-to-severe plaque psoriasis in a real-world clinical setting

Secukinumab for Treatment of Plaque Psoriasis in Real-World Clinical Practice in Spain: A Literature Review

Background/Objectives: Secukinumab was shown to be effective in treating moderate-to-severe plaque psoriasis in adults and pediatric patients ≥6 years. Methods: A literature review was conducted to identify studies published in the preceding 5 years assessing the effectiveness and/or survival (safety in the second instance) associated with secukinumab treatment for moderate-to-severe plaque psoriasis with/without psoriatic arthritis (PsA) in real-world clinical practice in Spain. Results: 11 references were included, corresponding to seven studies (six retrospective and one prospective) (n = 1050). Baseline characteristics were mean age 46.5-53.0 years; 28.7-55.0% women; 30.0-53.1% patients with PsA; 27.9-47.4% naïve to biologic treatments; mean Psoriasis Area and Severity Index (PASI) score 12.5 (standard deviation [SD]: 6.9)-18.1 (SD: 10.3). PASI 90 response rates were 54-65% at Week 24 and 46-63% at Week 52; 43-47% of patients showed PASI ≤ 1 at Week 12 and 47-56% at Week 52. Treatment persistence at Week 52 was 72-89%, being 74.5% in the larger cohort series (n = 384) at 2 years. Adverse-event-related treatment discontinuation was rare. Conclusions: Secukinumab demonstrated long-term safety and efficacy in treating adult patients with moderate-to-severe plaque psoriasis in actual clinical practice, with survival rates of up to two years and consistent efficacy in Spain.

Efficacy, drug survival, safety and metabolic parameters of ixekizumab in patients with moderate-to-severe psoriasis in China: A two-year real-world study

Long-term, real-world studies of the efficacy and metabolic parameters of ixekizumab in difficult-to-treat areas of psoriasis are lacking. A two-year retrospective study was conducted to evaluate the long-term efficacy, safety, drug survival and metabolic parameters of ixekizumab in the real world. A total of 258 patients were enrolled. At 52 weeks, PASI 75/90/100 was achieved in 92.0 %, 79.8 % and 54.6 % of patients, respectively. The efficacy was maintained at week 104 with PASI 75/90/100 of 92.6 %, 81.5 % and 48.1 %, respectively. At week 12, sPGA 0/1 was achieved in 71.0 % of scalp psoriasis, 60.0 % of palmoplantar psoriasis and 68.8 % of genital psoriasis. The probability of drug survival at 12 and 24 months was 67.1 % and 56.3 %, respectively. The most common adverse events included local injection reactions (31.8 %), allergies (11.6 %) and infections (6.1 %). No disease activation was observed in patients with latent tuberculosis or hepatitis B/C. No hyperlipidemia or hyperglycemia was observed. This study confirmed the long-term efficacy, high drug survival and favorable safety of ixekizumab in a real-world setting.

The Effects of Cardiometabolic Comorbidities on Biologic Treatment for Psoriasis with Respect to PASI Scores: A Qualitative Systematic Review

Objective

Cardiometabolic risk factors have been shown to decrease biologic efficacy in patients treated for inflammatory conditions. The purpose of this systematic review is to provide a qualitative evaluation of studies investigating biologic response among psoriasis patients with cardiometabolic comorbidities.

Methods

A comprehensive review was conducted according to the Preferred Reporting Guidelines for Systematic Reviews and Meta-Analysis guidelines to screen for studies including patients with cardiometabolic risk factors receiving biologic therapy for psoriasis. Studies not including a Psoriasis Area and Severity Index (PASI) score to evaluate treatment outcomes were not included. All studies underwent quality/bias analysis using the Methodological Index for Non-Randomized Studies (MINORS) scale.

Results

Obesity and Body Mass Index (BMI) were the most studied cardiometabolic risk factors. The majority of the studies reported a lower frequency of achieving PASI75 and PASI90 response with increasing BMI/obesity rates. Diabetes and hypertension showed similar findings but were not studied as frequently. Hyperlipidemia and other lipid disorders were less frequently studied.

Conclusion

Relationships between cardiometabolic risk factors and lower frequencies of achieving PASI75/90 exist in current literature. This qualitative systematic review reports evidence of lower PASI75 and PASI90 response rates in the presence of cardiometabolic risk factors.

Durability and long-term outcomes of biologic therapies in psoriasis

INTRODUCTION

Significant advances in psoriasis treatment have taken place since the introduction of biologics. Tumor necrosis factor inhibitors were the first class of biologics approved and at that time greatly improved psoriasis treatment. However, newer biologics, directed to interleukin(IL)-23/IL-17 pathways central to psoriasis pathogenesis, have improved complete or nearly complete clearance rates and are characterized by an excellent safety profile.Real-world setting experiences have generally confirmed the results of clinical trials, but real-world data regarding newer biologics is relatively scarce.

AREAS COVERED

We provide an extensive review of real-world survival of biologic treatments for moderate to severe psoriasis.

EXPERT OPINION

There is growing and consistent evidence of higher drug survival of IL-23 inhibitors, possibly due to their favorable efficacy and safety profiles, dosing convenience and persistence of response despite treatment interruption; eventual confirmation of their potential role as modifiers of the natural history of psoriasis might provide additional reasons for therapeutic persistence of this class of biologics.