Biologics: Targets & Therapy (Nov 2021)

Treatment with Ixekizumab Following Secukinumab Failure in Patients with Psoriatic Arthritis: Real-Life Experience from a Resistant Population

  • Berman J,
  • Furer V,
  • Berman M,
  • Isakov O,
  • Zisman D,
  • Haddad A,
  • Elkayam O

Journal volume & issue
Vol. Volume 15
pp. 463 – 470

Abstract

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Julia Berman,1,2,* Victoria Furer,2,3,* Mark Berman,2,3 Ofer Isakov,1,2 Devy Zisman,4,5 Amir Haddad,4 Ori Elkayam2,3 1Department of Medicine ‘T’, Sourasky Medical Center, Tel Aviv, Israel; 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Department of Rheumatology, Sourasky Medical Center, Tel Aviv, Israel; 4Rheumatology Unit, Carmel Medical Center, Haifa, Israel; 5The Ruth and Bruce Rappaport Faculty of Medicine,Technion, Haifa, Israel*These authors contributed equally to this workCorrespondence: Julia Berman Email [email protected]: To assess the clinical response to ixekizumab following secukinumab failure in patients with psoriatic arthritis.Methods: A retrospective multi-center observational study included psoriatic arthritis (PsA) patients with a history of treatment with secukinumab, further treated with ixekizumab. Primary endpoint was primary response to treatment (drug survival > 6 months); secondary endpoints were changes in disease activity indices from initiation of ixekizumab to 6 and 12 months later and overall drug survival.Results: Of 23 PsA patients, 86% (n = 20) received more than two TNF inhibitors (TNFi). Median secukinumab treatment time was 15 months (IQR 10– 21.5 months). Subsequently, 19 patients (83%) had a primary response to ixekizumab. Overall treatment duration during follow-up period for primary responders was 14 months (IQR 10– 20.5). Reasons for ixekizumab cessation were worsening psoriasis (27%), peripheral arthritis (27%), both (47%), worsening of axial disease (13%), and adverse events (6%). Articular disease indices including Disease Activity Index for Psoriatic Arthritis (DAPSA), tender joints count (TJC) and Simplified Disease Activity Index (SDAI) were significantly lower at 6 and 12 months (DAPSA 1.5– 2 levels reduction; p = 0.018 and 1– 1.5 levels reduction; p = 0.031, respectively; TJC − 2.16 [− 4.0, − 0.3]; p = 0.025 and − 1.69 [− 3.09, − 0.28]; p = 0.022, respectively; SDAI − 10.13 [− 16.4, − 3.8], p = 0.003 and − 12.2 [− 17.1, − 7.2], p = 0.0002, respectively). PASI75 at 6 and 12 months was achieved by 63% and 57%, respectively, and PASI100 at 6 and 12 months by 31% and 21%, respectively.Conclusion: Patients with resistant PsA, including inadequate response to secukinumab, demonstrated a good response to ixekizumab, albeit limited on time. Within class switch from secukinumab to ixekizumab may be a plausible therapeutic option in PsA patients following secukinumab failure.Keywords: secukinumab, ixekizumab, arthritis, psoriatic, duration of therapy, antibodies, monoclonal, humanized, psoriasis

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