Psoriasis Outcomes with Ixekizumab Impacted by Interrupted Therapy

Outcomes were assessed for those receiving continuous ixekizumab vs. those whose therapy was interrupted
Outcomes were assessed for those receiving continuous ixekizumab vs. those whose therapy was interrupted

Compared to psoriasis patients who interrupted therapy with ixekizumab, those who were continuously treated maintained high levels of response, a study published in the Journal of the European Academy of Dermatology and Venereology reported. 

It is recommended that patients with moderate-to-severe psoriasis receive continuous treatment, but sometimes interruptions may be needed in routine clinical care. Study authors aimed to assess the outcomes in psoriasis patients receiving continuous ixekizumab vs. those whose therapy was interrupted and then subsequently restarted with ixekizumab. 

Pooled data from the Phase 3 trials, UNCOVER-1 and UNCOVER-2 were analyzed. Patients were randomized to placebo, ixekizumab every 4 weeks or ixekizumab every 2 weeks for 12 weeks. Those with a static sPGA score of 0,1 at Week 12 were re-randomized to ixekizumab every 4 weeks or every 12 weeks or placebo. 

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A total of 1,226 patients who achieved an sPGA of 0,1 at Week 12 entered the maintenance phase. Of these, 402 were re-randomized to placebo and 416 to ixekizumab every 4 weeks. Among the patients who had interrupted treatment, 82.2% of the ixekizumab every 4 weeks/placebo (IXEQ4W/PBO) group and 83.4% of the ixekizumab every 2 weeks/placebo (IXEQ2W/PBO) group had an sPGA ≥3 by Week 60. The median time to relapse was approximately 20 weeks regardless of induction dose.

By Week 60, patients receiving continuous treatment sustained high levels of PASI and sPGA responses (90% PASI 75, 81.9% sPGA 0,1). Following 24 weeks of retreatment with ixekizumab every 4 weeks, 87% of IXEQ2W/PBO group  and 95.1% of IXEQ4W/PBO group recaptured PASI 75; 70.7% and 82.3% recaptured sPGA 0,1, respectively. 

Overall, high levels of response were seen with continuous ixekizumab treatment through 60 weeks. Most patients who were withdrawn had disease relapse, and most of those patients seemed to recapture response after 24 weeks of retreatment. 

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