Safety and Tolerability of Ixekizumab: Integrated Analysis of Injection-Site Reactions from 11 Clinical Trials
February 2018 | Volume 17 | Issue 2 | Original Article | 200 | Copyright © 2018
Neil H. Shear MD FRCPC,a Carle Paul MD PhD,b Andrew Blauvelt MD MBA,c Melinda Gooderham MD MSc FRCPC,d Craig Leonardi MD,e Kristian Reich MD PhD,f Mamitaro Ohtsuki MD PhD,g Beth Pangallo RN,h Wen Xu PhD,h Susan Ball PhD,h Terri Ridenour MBA BSN,h Hitoe Torisu-Itakura MD PhD,i Noah Agada, MD MPH,h and Lotus Mallbris MD PhDh
aSunnybrook Health Sciences Centre, Dermatology, Clinical Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada bCHU and Paul Sabatier University, Toulouse, France cOregon Medical Research Center, Portland, OR dSKIN Centre for Dermatology, Queen’s University and Probity Medical Research, Peterborough, ON, Canada eSt. Louis University School of Medicine, St. Louis, MO fDermarologikum Hamburg and SCIderm Research Institute, Hamburg, Germany gJichi Medical University, Tochigi, Japan hEli Lilly and Company, Indianapolis, IN iEli Lilly Japan KK, Hyogo, Japan
BACKGROUND: Injection-site reactions (ISRs) are reported with biologic therapies. The objective of this study was to comprehensively characterize ISRs among moderate-to-severe psoriasis patients treated with ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin (IL)-17A.
METHODS: ISRs are presented from UNCOVER-1, UNCOVER-2, and UNCOVER-3 (12 weeks) and all ixekizumab-exposed patients in 11 controlled and uncontrolled trials (156 weeks).
RESULTS: At week 12, reported ISR frequency with 80 mg ixekizumab every 2 weeks (IXE Q2W, 16.8%) was comparable with etanercept twice weekly (16.4%); both were significantly higher than placebo (3.3%). With IXE Q2W, ISRs were mild (12.3%), moderate (3.9%), or severe (0.7%), typically reported in the first 2 weeks (median onset, 6.6 days), and most commonly characterized as nonspecified, erythema, and pain. Generally, erythema onset was delayed, whereas pain occurred around drug administration. Discontinuation from ixekizumab due to ISRs (0.4%) occurred in the first 12 weeks. After 2 weeks, ISR frequency decreased and remained stable (≤4.2%) through week 156. No ISR-related serious adverse events were reported in ixekizumab-treated patients. ISR data were solicited if patients reported injection-associated events. Since nonspecified ISR was the most commonly reported term, specific types might be underreported.
CONCLUSIONS: ISRs have been reported with ixekizumab during clinical trials. These reactions are typically tolerable, manageable, and decrease over time.
Clinicaltrials.gov: NCT01474512 (UNCOVER-1); NCT01597245 (UNCOVER-2); NCT01646177 (UNCOVER-3); NCT01777191 (UNCOVER-A); NCT01624233 (UNCOVER-J); NCT01107457 (I1F-MC-RHAJ); NCT02561806 (I1F-MC-RHBS); NCT02387801 (I1F-US-RHBO);NCT02513550 (I1F-MC-RHBP); NCT02634801 (I1F-EW-RHBZ)
J Drugs Dermatol. 2018;17(2):200-206.
THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE.
PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN.
NO PURCHASE NECESSARY.
PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
Purchase Original Article
Purchase a single fully formatted PDF of the original manuscript as it was published in the JDD.
Download the original manuscript as it was published in the JDD.
Contact a member of the JDD Sales Team to request a quote or purchase bulk reprints, e-prints or international translation requests.
To get access to JDD's full-text articles and archives, upgrade here.
Save an unformatted copy of this article for on-screen viewing.
Print the full-text of article as it appears on the JDD site.→ proceed | ↑ close
During the last decade, biologic therapies have contributed to the revolution of treatment for moderate-to-severe plaque psoriasis. Common adverse events that have been noted with biologics are injection-site reactions, which are typically defined as local skin reactions occurring after an injection and are often characterized by erythema, edema, and/or pain.1-3 Some injection-site reactions may represent a type of hypersensitivity reaction to the active agent or to one of the components of the formulation.4 The etiology of injection-site reactions can be multifactorial, nonspecific, and may include immunologic and non-immunologic factors such as volume, temperature, pH, speed of injection, and needle size, among others.3Ixekizumab, a high-affintiy monoclonal antibody that selectively targets interleukin (IL)-17A, was recently approved for treatment of moderate-to-severe psoriasis. The efficacy of ixekizumab has been established to be superior to placebo,