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Ixekizumab and Complete Resolution of Enthesitis and Dactylitis

IL-17 inhibitors have proven to be effective in psoriatic arthritis (PsA). Analyses of ixekizumab-treated PsA patients with enthesitis or dactylitis shows this approach to yield significant improvements in enthesitis and dactylitis.

Gladman et al analyzed data from SPIRIT-P1 and SPIRIT-P2 clinical trials wherein patients were treated with either 80-mg ixekizumab every 4 weeks (IXEQ4W) or 2 weeks (IXEQ2W), after a 160-mg starting dose, or to placebo.

Enthesitis was assessed using the Leeds Enthesitis Index [LEI] and dactylitis assessed using the Leeds Dactylitis Index-Basic [LDI-B].

The analysis included 679 patients; of whom 60% (n = 403)had baseline enthesitis (LEI > 0) and 23% (n = 155 of 676) had baseline dactylitis (LDI > 0).

At week 24, total resolution of was significantly higher than placebo for enthesitis (39% IXEQ4W, 35% IXEQ2W, 21% placebo) and dactylitis (78% IXEQ4W, 65% IXEQ2W, 24% placebo).

At week 24, resolution of enthesitis was associated with improvements in function and HRQoL whereas dactylitis resolution was associated with more limited improvements. 

In PsA patients with enthesitis or dactylitis, IXE improvements in enthesitis and dactylitis were associated with overall improvements in patients’ function, pain, and HRQoL.

The author has received compensation as an advisor or consultant on this subject

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