Journal of Inflammation Research (Dec 2021)
Ixekizumab for Psoriatic Arthritis: Safety, Efficacy, and Patient Selection
Abstract
John Miller,1,2 Abin P Puravath,1 Ana-Maria Orbai1,3 1Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Psoriatic Arthritis Program, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Ana-Maria OrbaiJohns Hopkins Division of Rheumatology, 5200 Eastern Avenue, MFL Center Tower Suite 4100, Baltimore, MD, 21043 Tel +1 410 550 8231Fax +1 410 550 2072Email [email protected]: Ixekizumab is a monoclonal antibody targeting IL-17A and licensed for psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis. Review objectives were to summarize: 1) ixekizumab safety in people with PsA, 2) ixekizumab efficacy from Phase III randomized controlled trials, and 3) ixekizumab study participant PsA phenotypes.Methods: We conducted a search in PubMed limited to phase III randomized controlled trials (RCT) and corresponding long-term extension studies where the intervention was treatment with ixekizumab in a population with PsA.Results: We identified 17 publications and 13 met inclusion criteria. Injection site reactions (ISR) and allergic reactions occurred in up to 25.3% and 6.2% with ixekizumab and 4.5% and 1.85, respectively, with placebo. ISR occurred in 9.5– 10.6% at 24 and 52 weeks with ixekizumab versus 3.2– 3.5% with adalimumab (p 92%.Conclusion: Ixekizumab treatment in PsA was associated with a statistically significant higher risk of injection site reactions versus placebo or adalimumab. Ixekizumab had statistically significantly fewer serious adverse events than adalimumab. Ixekizumab demonstrated efficacy for all PsA disease activity domains as well as for slowing radiographic disease progression. The main shortcoming of the ixekizumab PsA program is lack of representation of African American study participants.Keywords: ixekizumab, psoriatic arthritis, interleukin-17 inhibitor, clinical trials, biologic therapy
