Benefits Over Five Years of Ixekizumab Treatment in Patients With Psoriasis Involving Challenging Body Areas
August 2024 | Volume 23 | Issue 8 | 8160 | Copyright © August 2024
Published online July 26, 2024
Alice B. Gottlieb MD PhDa, April Armstrong MDb, Andrew Blauvelt MD MBAc, Christopher E. M. Griffiths MDd,e, Andreas Pinter MDf, Melinda Gooderham MDg, Mark Lomaga MDh, Russel T. Burge PhDi,j, Bruce W. Konicek MSi, Meghan Feely McDonald MDa,i, Kyoungah See PhDi, Missy McKean-Matthews MSk, Tomotaka Mabuchi MDl
aIcahn School of Medicine at Mount Sinai, New York, NY
bKeck School of Medicine, University of Southern California, Los Angeles, CA
cOregon Medical Research Center, Portland, OR
dCentre for Dermatology Research, University of Manchester, Manchester, UK
eKing's College Hospital, King’s College London, London, UK
fDepartment of Dermatology, Venerology, and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
gSKiN Centre for Dermatology, Peterborough, ON, Canada
hDermEdge Research and Probity Medical Research, Mississauga, ON, Canada
iEli Lilly and Company, Indianapolis, IN
jDivision of Pharmaceutical Sciences, University of Cincinnati, Cincinnati, OH
kSyneos Health, Raleigh, NC
lDepartment of Dermatology, Tokai University School of Medicine, Isehara, Japan
Abstract
Background: Psoriasis involving challenging body areas, such as the scalp, face, palmoplantar surfaces, or nails, can be challenging to treat and negatively affects patient outcomes.
Objective: To assess clear responses and cumulative clinical benefits over 5 years of ixekizumab treatment of moderate-to-severe plaque psoriasis in patients with and without baseline involvement of challenging body areas.
Methods: This post hoc analysis included patients treated with ixekizumab in the UNCOVER-3 trial. We assessed PASI100 responses through the week (W) 264 and cumulative clinical benefits at W264 (calculated as least-squares mean of the percentage of maximum area under the curve for PASI100 and PASI% improvement and expressed as cumulative clearance days). Statistical differences were calculated via ANCOVA.
Results: A total of 385 patients were analyzed: 349 with scalp involvement, 152 with facial involvement, 96 with palmoplantar involvement, and 229 with nail involvement. Proportions of patients achieving PASI100 were numerically similar between patients with and without scalp and nail involvement. More patients without facial and palmoplantar involvement achieved PASI100 at W60 (only palmoplantar), W108, W156, W204, and W264 (only palmoplantar). At W264, cumulative clinical benefits for PASI100 and PASI% improvement were high and similar in both patient groups, with and without challenging body areas. A significant difference (P=0.006) was only observed for PASI% improvement between patients with and without nail involvement.
Conclusion: For most efficacy measures, patients treated with ixekizumab over 5 years achieved similar clear responses and cumulative clinical benefits regardless of baseline involvement of challenging body areas.
J Drugs Dermatol. 2024;23(8): doi:10.36849/JDD.8160
INTRODUCTION
Challenging body areas include the scalp, face, palmoplantar surfaces (ie, palms and soles), nails, intertriginous areas, and genitalia. Psoriasis involving challenging body areas is associated with a higher degree of disease severity,1,2 and can be challenging to treat.3,4 Additionally, psoriasis involving challenging body areas carries a significant burden on patients, disproportionately impacts their quality of life,5-7 and has worse patient-reported outcomes.6 Furthermore, patients with psoriasis involving the face have a higher risk of psoriasis in the scalp, genitalia, and nails; similarly, patients with psoriasis involving the soles have a higher risk of palms and nail involvement.8
