Ixekizumab leads to plaque psoriasis resolution, improves quality of life

VANCOUVER, British Columbia — Patients who achieved near complete resolution of plaque psoriasis with ixekizumab treatment had greater improvement in quality of life, according to research presented at the World Congress of Dermatology.

Chris Griffiths, BSc, MD, foundation professor and chair of dermatology at the University of Manchester, United Kingdom, reported that while “currently [Psoriasis Area and Severity Index (PASI)] score 75 is considered a good treatment goal for psoriasis symptoms,” individuals not achieving complete resolution of skin may have continued impairment of health-related quality of life.

Chris Griffiths

Griffiths and colleagues randomly assigned 1,224 patients to receive subcutaneous placebo, Enbrel (etanercept, Amgen) 50 mg twice weekly, or a ixekizumab (Eli Lilly) 80 mg in a single injection every 2 weeks or every 4 weeks, following an initial starting dose of 160 mg. Itch Numerical Rating Scale (Itch NRS), and the Dermatology Life Quality Index (DLQI) were used as measurements. Patients were divided into fived groups: less than 50% improvement in PASI (n=354); 50% to 75% improvement in PASI (n=134); 75% to <90% improvement in PASI (n=213); 90% to <100% improvement in PASI (n=254); and 100% in PASI (n=269). Improvements in DLQI and itch at week 12 were compared pairwise.

Up to 75% of patients treated with ixekizumab achieved PASI 75 at week 12, Griffiths reported. Sixty percent to 70% of patients in the ixekizumab cohorts achieved PASI 90 compared with 19% of patients on etanercept. PASI 100 was achieved by 30% to 40% of patients treated with ixekizumab, compared with 5% of patients with etanercept, Griffiths reported.

The PASI 100 cohort had greater improvements in DLQI and Itch NRS (P<0.01). Significantly greater reductions in itch NRS when compared with the PASI 75 to <90 cohort (-5.9 vs. -4.6, respectively; P<.01). When compared with the PASI 75 to <90 cohort, a DLQI score of 0 was achieved by more patients in the PASI 100 (59% vs. 24%, P<.05), as was a DLQI score of 0 or 1 (78% vs. 53%; P<.01).

Griffiths reported that serious adverse events were not greater between patients achieving lower PASI scores and those who neared PASI 100.

“The majority of patients treated with ixekizumab achieved complete or near complete resolution of plaque psoriasis after 12 weeks,” Griffiths concluded. “PASI 100 and PASI 90 were associated with greater improvements in symptoms and quality of life compared with patients achieving PASI 75 to PASI 89.”

“Complete or near complete resolution of plaques in psoriasis may be a potential treatment goal,” he added. – by Bruce Thiel

Reference:

Griffiths C., et al. FC24-05. Complete Resolution of Psoriasis is Associated with Greater Improvements in Itch and Health-Related Quality of Life: An Analysis from Undercover-2, a Phase 3 Clinical Trial of Ixekizumab. Presented at: 23rd World Congress of Dermatology; June 8-13, 2015; Vancouver, British Columbia.

Disclosure: Griffiths reports serving on the advisory board and receiving research grants from Eli Lilly, Sandoz and Novartis and Celgene, on the advisory board, as a consultant and speaker for Amgen, on the advisory board and as a speaker for Janssen, on the advisory board receiving research grants and as a speaker for Pfizer, as a consultant and receiving research grants for Leo and receiving research grants from AbbVie and Trident. The other researchers’ relevant financial disclosures were not available at time of publication.