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Long-Term Benefits of Ixekizumab in Psoriatic Arthritis

Nov 03, 2020 1:04 pm

The SPIRIT-P1 study has demonstrated the safety and efficacy of ixekizumab (an IL-17A antagonist) when given to adults w/ active psoriatic arthritis (PsA), and also demonstrating radiographic protection and improvement in skin outcomes as well. 

This phase 3 study, enrolled biologic-naïve active PsA patients who randomly given either placebo, adalimumab 40 mg every 2 weeks (ADA) or ixekizumab 80 mg every 2 weeks (IXEQ2W) or every 4 weeks (IXEQ4W) after an initial dose of 160 mg. At week 16 or 24 ADA and placebo patients were re-randomized to IXEQ2W or IXEQ4W.

Of 417 patients, 381 entered the extension, and 243 of 381 (63.8%) completed the 156-week study.

Incidence rates of serious adverse events were 5.2 with IXEQ2W (n = 189) and 8.0 with IXEQ4W (n = 197).  There was only one death (IXEQ4W group).

The week 156 response rates for IXEQ2W and IXEQ4W, respectively were:

  • ACR20: 62.5 and 69.8%
  • ACR50: 56.1 and 51.8%
  • ACR70: 43.8 and 33.4%
  • Psoriasis area and severity index (PASI) 75: 69.1 and 63.5%
  • PASI 90: 64.5 and 51.2%
  • PASI 100: 60.5 and 43.6%.

Inhibition of radiographic progression also persisted to week 156 in 61% of IXEQ2W and 71% of IXEQ4W patients.

The long term efficacy and safety of ixekizumab in PsA was observed, along with persistent low rates of radiographic progression.

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

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