Ixekizumab, brodalumab show strongest clinical benefit in psoriasis

Both ixekizumab and brodalumab were associated with better clinical benefit than other biologic therapies over 12 weeks or 16 weeks of treatment for psoriasis, according to a meta-analysis.

“Cumulative clinical improvement and speed of improvement are important to psoriasis patients,” Richard B. Warren, MD, PhD, of the Salford Royal NHS Foundation Trust at the University of Manchester, Manchester NIHR Biomedical Research Centre in the U.K., and colleagues wrote. “Although cumulative life course impairment is a theoretical construct referring to the burden of disease over a long period of time, evaluating the cumulative

clinical benefit, even over the first 12 to 16 weeks of treatment, can improve understanding of the impact of treatment on the patient.”

Warren and colleagues conducted a systematic literature review to compare the cumulative benefits of biologics that had available data for 12 to 16 weeks of treatment in patients with moderate to severe psoriasis.

Eligible analyses were phase 3 trials that measured Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 responses.

The analysis included 714 studies, of which 245 were full-text publications and 469 were conference abstracts. The final data set included 28 articles that met criteria.

Both ixekizumab and brodalumab were associated with better clinical benefit than other biologic therapies over 12 weeks or 16 weeks of treatment for psoriasis, according to a meta-analysis.

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Anti-IL-17 therapies bested anti-IL-23 therapies and other biologics with consistently greater cumulative clinical benefits as assessed by PASI 75, PASI 90 and PASI 100 outcomes. These findings were reported for treatment durations of 12 weeks and 16 weeks.

In studies looking at 12-week outcomes, Taltz (ixekizumab, Lilly) and Siliq (brodalumab, Bausch Health) bested Cosentyx (secukinumab, Novartis), Tremfya (guselkumab, Janssen), Remicade (infliximab, Janssen), Humira (adalimumab, AbbVie), Stelara (ustekinumab, Janssen) and Enbrel (etanercept, Amgen) as assessed by these endpoints.

In studies evaluating 16 weeks of therapy, ixekizumab was associated with better cumulative benefits than any other drug.

“Maximum cumulative clinical benefit percent achieved is a useful metric for capturing the speed and magnitude of clinical responses for psoriasis biologics and may help clinicians differentiate among treatment choices for their patients,” Warren and colleagues said. – by Rob Volansky

Disclosures: Warren reports serving as an adviser and/or clinical investigator for AbbVie, Almirall, Boehringer Ingelheim, Celgene, Eli Lilly and Company, GlaxoSmithKline, Janssen, Leo Pharma, Merck Sharp & Dohme, Novartis, Sanofi Genzyme and UCB Pharma and as a paid speaker for AbbVie, Almirall, Amgen, Celgene, Eli Lilly and Company, Janssen, Leo Pharma, Novartis, Sanofi Genzyme and UCB Pharma. Please see the study for all other authors’ relevant financial disclosures.