Thursday, 25 Apr 2019

You are here

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.

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

Add new comment

More Like This

Skyrizi (risankizumab) FDA Approved for Psoriasis

AbbVie has announced that the US FDA has granted the approval of Skyrizi (risankizumab-rzaa) for the treatment of moderate to severe plaque psoriasis. 

Skyrizi is an interleukin-23 (IL-23) inhibitor that was also recently approved in Canada and Japan. Skyrizi is the third IL-23 inhibitor (behind guselkumab [Tremfya] and tildrakizumab [Ilumya]) to be approved in the last year.

Higher Comorbidities in Hidradenitis Suppurativa

JAMA Dermatology reports that patients with hidradenitis suppurativa have significantly more comorbidities than do patients with psoriasis.

A cross-sectional study compared 5306 HS patients, 14 037 patients with psoriasis, and 1 733 810 controls from electronic health records between 2013 and 2018. Specifically they examined comorbidities using the Charlson Comorbidity Index (CCI) score.

Biologic Agents have Equal Efficacy in Enthesitis and Dactylitis

A systematic review has shown that TNF inhibitors (TNFi) are equaled in efficacy by other biologic agents (ustekinumab, secukinumab, and ixekizumab) in psoriatic arthritis (PsA) patients with in dactylitis and enthesitis.

The literature review analyzed datafrom randomized controlled trials (RCTs) with TNFi (infliximab, golimumab, adalimumab), antiinterleukin- 12/23 (ustekinumab) and anti-interleukin-17 (secukinumab, ixekizumab).

Dual IL-17 Inhibitor in Psoriasis Succeeds

Patients with moderate-to-severe plaque psoriasis attained durable complete and near-complete responses for more than a year with a dual inhibitor of interleukin (IL)-17, data from a randomized trial showed. 

AAD/NPF Guidelines on Biologic Use in Psoriasis

Menter and colleagues from the American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF) have published their expert consensus guidelines for the use of biologics in psoriasis.