Ixekizumab vs Guselkumab: Efficacy Compared in Plaque Psoriasis Trial

A greater proportion of patients with moderate to severe plaque psoriasis achieved complete skin clearance with ixekizumab when compared with guselkumab, according to results from a phase 4 head-to-head study.

In the IXORA-R study, patients (N=1027) were randomized to receive ixekizumab, an interleukin (IL)-17A antagonist (160mg SC at Week 0, followed by 80mg at Weeks 2, 4, 6, 8, 10, and 12, then 80mg every 4 weeks) or guselkumab, an IL-23 antagonist (100mg SC at Week 0, Week 4, and every 8 weeks thereafter) for 24 weeks. 

The primary outcome measure was the proportion of patients achieving 100% improvement from baseline in Psoriasis Area and Severity Index (PASI 100) at Week 12; major secondary end points included the proportion of patients achieving PASI 50 at Week 1, PASI 75 at Week 2, PASI 90 at Weeks 4 and 8, PASI 100 at Weeks 4, 8, and 24, and the proportion of patients achieving a Static Physician Global Assessment (sPGA) score of 0 at Week 12.

Findings from the study showed that treatment with ixekizumab resulted in a greater proportion of patients achieving PAS100 at Week 12, when compared with guselkumab. In addition, ixekizumab demonstrated superiority over guselkumab in all major secondary end points. Additional data on another key secondary end point (proportion of patients achieving PASI 100 at 24 weeks) are expected to be released in 2020.

Both ixekizumab (Taltz; Lilly) and guselkumab (Tremfya; Janssen) are currently approved for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.

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