- Obiettivo del presente studio è stato descrivere l’esperienza real-world dei pazienti con psoriasi che hanno iniziato ixekizumab dopo un precedente biologico e di comparare l’efficacia di ixekizumab dopo il fallimento terapeutico con secukinumab rispetto agli altri biologici.
- I risultati suggeriscono che i pazienti che sono passati ad ixekizumab dopo un altro biologico hanno avuto un miglioramento della severità della malattia dopo circa 6 mesi.
- I pazienti che hanno interrotto un biologico differente rispetto a secukinumab sembrano rispondere maggiormente a ixekizumab rispetto a quelli che hanno assunto secukinumab.
Abstract
Introduction & objectives
The aim of this work is to describe real-world biologic-experienced psoriasis patients initiating ixekizumab by prior biologic therapy status and compare the effectiveness of ixekizumab between patients who previously failed secukinumab and those who failed other biologics. We hypothesized that (1) clinical outcomes and patient-reported outcomes would improve following a switch to IXE, and (2) there would be no differences in responses between patients who previously failed secukinumab and those who failed other biologics.
Methods
Participants (n = 419) included adult psoriasis patients enrolled in the CorEvitas Psoriasis Registry through 9/10/20 who switched to ixekizumab after discontinuing another biologic. Patients were classified by the biologic used immediately prior to ixekizumab and reason for discontinuation: prior secukinumab failure; prior secukinumab non-failure; prior other biologic failure; and prior other biologic non-failure. Discontinuations for efficacy reasons were considered failures; all others were considered non-failures. Baseline descriptive statistics were calculated. Multivariable Poisson regression models estimated the likelihood of response of other failure relative to secukinumab failure.
Results
Mean age was 51 years; 48% were women. Psoriasis disease characteristics were similar across prior biologic groups. At 6-month follow-up, disease severity improved for all who initiated ixekizumab after discontinuing another biologic. Secukinumab failure patients who switched to ixekizumab achieved BSA ≤1 (49%), BSA ≤3 (59%), PASI75 (46%), PASI ≤3 (64%), and IGA ≤1 (40%). Other failure patients achieved BSA ≤1 (55%), BSA ≤3 (72%), PASI75 (59%), PASI ≤3 (74%), and IGA ≤1 (54%). In regression modeling, we observed patients in the other biologics failure group had an increased likelihood of achieving response for BSA ≤3, PASI75, PASI90, PASI100, and IGA ≤1 compared to patients who failed secukinumab.
Conclusions and perspectives
These findings suggest that patients with psoriasis who switch to ixekizumab after discontinuing another biologic demonstrate improvement in disease severity after six months. Patients who discontinued biologics other than secukinumab may be more likely to respond to ixekiziumab compared to those who switched from secukinumab.