Ixekizumab (Taltz) may be effective to treat patients with psoriatic arthritis (PsA) who are not be able to receive anti-tumor necrosis factor (anti-TNF) inhibitors, according to a recent study presented at the British Society for Rheumatology Annual Conference, which was held from May 1 through 3 in Liverpool, England.
In the double-blind, placebo-controlled trial, 363 participants with PsA unresponsive to 1 or 2 anti-TNF inhibitors or those who were TNF-intolerant were randomized to 80 mg of subcutaneous ixekizumab every 2 weeks or 4 weeks or placebo after an initial 160 mg dose at baseline. Participants who showed inadequate response at week 16 received rescue therapy. The primary endpoint was improvement in American College of Rheumatology (ACR) score by 20% or more at week 24. In addition, the researchers assessed skin outcomes, and patient reported outcomes, and safety. Overall, 87% of participants completed the study. ___________________________________________________________________________________________________________________________
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Compared with participants who received placebo, those treated with ixekizumab were significantly more likely to achieved ACR20, ACR50, ACR70, minimal disease activity, and reductions in functional disability by week 24. Likewise, a significantly higher proportion of participants who received ixekimuab every 4 weeks achieved complete resolution of dactylitis compared with placebo. Ixekizumab was associated with improved enthesitis, significantly more participants achieving an itch numeric rating scale of 0, itch resolution or Dermatology Life Quality Index (DLQI) score of 0 or 1, improvements in body surface area by 3% or more on the Psoriasis Area Severity Index, and significantly greater improvements in patient-reported outcomes compared with placebo.
While there was a higher incidence of injection site reactions among participants who received ixekizumab, the majority were mild. Otherwise, the incidence of treatment-emergent adverse events was similar across groups.
“Ixekizumab improved arthritis, physical function, psoriasis and DLQI compared to placebo with no unexpected safety findings in patients with active PsA who had inadequate response or intolerance with prior TNF-inhibitors,” the researchers concluded.
Marzo-Ortega H, Meroni P, Galindez-Agirregoikoa E, et al. Efficacy and safety of ixekizumab at week 24 in biologic experienced patients with active psoriatic arthritis summary results. Presented at: British Society for Rheumatology Annual Conference; May 1-3, 2018; Liverpool, England.