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IL-17 Superior to TNF Inhibition in Psoriatic Arthritis

Jul 14, 2020 12:21 pm

A one year head-to-head (H2H) trial has shown ixekizumab (IXE) to be superior to adalimumab (ADA) in psoriatic arthritis (PsA); for both skin and articular outcomes.

The SPIRIT H2H study was a 52-week trial of 566 biologic DMARD naive, PsA patients, randomized to received either IXE or ADA. The primary end point was at Wk 24, but the newly published data shows week 52 results for ACR50 and Psoriasis Area and Severity Index (PASI)100 responses. 

When looking a a combined ACR50 and PASI100 response, IXE was significantly better than ADA at week 52 (39% vs 26%, p<0.001). The PASI100 also favored IXE (64% vs 41%, p<0.001) at Wk52, However the articular (ACR50) outcomes showed ADA and IXE to be equal (49.8% vs 49.8%, p=0.924), as were enthesitis and dactylitis outcomes.

There were no new safety findings for IXE or ADA.

IXE produced a better combined skin/joint response than did ADA in bionaïve PsA patients, primarily with better efficacy in psoriasis, but was equal to ADA in treating musculoskeletal manifestations of PsA.

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

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