Interleukin-17A Inhibitors Superior to Others for Clearing Skin of Psoriasis Patients
A recent study found that interleukin-17A inhibitors were more effective than ustekinumab at achieving skin clearance among patients with moderate to severe plaque psoriasis.
In the systematic literature review, the researchers examined data from placebo-controlled randomized trials of 8 targeted immunomodulators used to treat adults with moderate to severe plaque psoriasis. Additionally, they conducted a meta-analysis that adjusted for placebo response to compare the agents. A 75% improvement on the Psoriasis Area and Severity Index (PASI 75%) was assessed as the primary outcome.
Immunomodulators associated with a greater likelihood of achieving PASI 75 in the meta-analysis were ixekizumab (relative risk [RR], 17.9), brodalumab (RR, 17.3), infliximab (RR, 16.2), secukinumab (RR, 15.4), ustekinumab (RR, 14.0), adalimumab (RR, 13.0), etanercept (RR, 9.6), and apremilast (RR, 6.2).
In addition, ixekizumab, brodalumab, and infliximab were statistically superior to ustekinumab, adalimumab, etanercept, and apremilast. These results were similar to findings from head-to-head studies.
“The interleukin-17A inhibitors are more effective in achieving clearance than ustekinumab, which are, in turn, generally more effective than etanercept, adalimumab, and apremilast,” the researchers concluded.
Loos AM, Liu S, Segel C, Ollendrof DA, Pearson SD, Linder JA. Comparative effectiveness of targeted immunomodulators for the treatment of moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis [published online February 10, 2018]. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2018.02.027