Long-term ixekizumab similarly efficacious in challenging body areas in psoriasis

Key takeaways:

• Psoriasis on the scalp, face, palmoplantar areas, nails, intertriginous area and genitalia is often hard to treat.
• This 5-year analysis found similar cumulative days response and PASI 100 response in patients with and without challenging area involvement.

Patients with moderate to severe psoriasis in hard-to-treat areas of the body who received ixekizumab experienced long-term success over 5 years, according to a study.

“Challenging body areas include the scalp, face, palmoplantar surfaces (ie, palms and soles), nails, intertriginous areas and genitalia,” Alice B. Gottlieb, MD, PhD, of the department of dermatology at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. “Psoriasis involving challenging body areas is associated with a higher degree of disease severity and can be challenging to treat.”

Patients in the randomized, double-blind, placebo-controlled, active-controlled phase 3 UNCOVER-3 clinical trial were randomly assigned to receive subcutaneous injections twice weekly of placebo, 50 mg etanercept or a loading dose of 160 mg of ixekizumab followed by 80 mg every 2 or 4 weeks for 12 weeks. For the long-term extension, all patients received ixekizumab through week 264.

A post-hoc analysis included data from 385 patients in the trial, of whom 349 had scalp involvement, 152 had facial involvement, 96 had palmoplantar involvement and 229 had nail involvement.

PASI 100 was achieved by similar rates among patients with and without scalp and nail involvement; however, more patients without vs. with facial involvement achieved PASI 100 at all time points, including week 264 (69.4% vs. 62.7%). This was also true of those without vs. with palmoplantar involvements (week 264, 51.2% vs. 70.6%).

Cumulative clinic benefits at week 264 were similar and not statistically significant for both those with and without challenging body area involvement. Only nail involvement showed a significant difference in cumulative days of clinical benefit for PASI percentage improvement (with, 1,678.9 days vs. without, 1,554.1 days; P = .006).

“In most instances, patients with moderate to severe plaque psoriasis treated with ixekizumab over 5 years achieved similar clearance responses and cumulative clinical benefits regardless of baseline involvement of the analyzed challenging body areas: scalp, face, palms, soles and nails,” the authors wrote.