Efficacy and safety of switching to ixekizumab in secukinumab nonresponders with plaque psoriasis: A multicenter retrospective study of interleukin 17A antagonist therapies

Georgakopoulos, Jorge R.; Phung, Michelle; Ighani, Arvin; Yeung, Jensen

doi:10.1016/j.jaad.2018.01.003

Cited by 45 publications

(36 citation statements)

References 5 publications

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“…In our population secukinumab failure mostly occurred because of loss of efficacy (76.2% of patients) after a mean treatment period of 45.1 weeks. We did not detect any correlation between reason for secukinumab discontinuation and response to ustekinumab, similarly to previous clinical experience in switching patients from an anti-IL-17A antagonist to another [14]. In contrast, the reason for discontinuation was reported to affect clinical outcomes (in terms of PASI 75 achievement) when switching between TNF-α inhibitors [5].…”

Section: Discussionsupporting

confidence: 79%

“…This effectiveness was associated with good tolerability, no harmful signals derived from switching, and the occurrence of only mild AEs, such as upper respiratory tract infections occurring in 23.8% patients. Previous studies described switching to ixekizumab after secukinumab failure [13, 14], but no data about using ustekinumab in secukinumab nonresponder patients were available. This study provided evidence that ustekinumab might be considered a safe and effective therapeutic option after failure of secukinumab.…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding the marked efficacy and the good safety profile, drug discontinuation with secukinumab has been observed but, currently, only a few reports describe switching experiences from secukinumab to other biologic therapies [2, 13-17]. Recent clinical reports described the efficacy and safety of switching from secukinumab to another anti-IL-17A agent, ixekizumab, but none reported clinical outcomes of switching from secukinumab to ustekinumab [13, 14]. The use of ustekinumab after secukinumab failure might be considered a vain attempt to control the disease because the efficacy of ustekinumab is thought to be pathogenically linked to the upstream suppression of IL-17A signaling, and thereby, the ineffectiveness of an IL-17A inhibitor, such as secukinumab, may represent a deterrent to the subsequent treatment with ustekinumab.…”

Section: Introductionmentioning

confidence: 99%

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Switching from Secukinumab to Ustekinumab in Psoriasis Patients: Results from a Multicenter Experience

et al. 2019

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Background: Switching between biologics is commonly performed for the management of plaque psoriasis. However, no evidence about switching from secukinumab to ustekinumab has been reported. Methods: This retrospective observational multicenter study aimed to describe efficacy and safety of ustekinumab in secukinumab nonresponder patients. Results: A total of 21 patients unresponsive to secukinumab were treated with ustekinumab for a mean period of 53.3 weeks. Ustekinumab was effective in reducing disease severity, with significant improvements of both psoriasis area severity index (PASI) and dermatology quality of life index (DLQI) scores. PASI score improvements of 31.8, 44, 77.8, 80.3, 80.5, and 89.6%, at week 4, 12, 24, 36, 48, and above 60 weeks, respectively, were detected (p < 0.05), achieving PASI 50, 75, and > 90 responses in 93.8, 87.5, and 50% of patients at week 48. Four patients withdrew from ustekinumab treatment because of inefficacy, and failure of multiple biologic agents (> 2) seemed to affect ustekinumab drug survival. No serious adverse events (AEs) were reported while 38.1% of patients experienced mild AEs. Conclusion: Ustekinumab was safe and effective in treating patients unresponsive to secukinumab.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Switching from Secukinumab to Ustekinumab in Psoriasis Patients: Results from a Multicenter Experience

et al. 2019

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“…Previous reports showed the efficacy of switching from secukinumab to ixekizumab only at 12 weeks . In our study, we extended follow‐up to 24 weeks, showing that ixekizumab might represent a valid and safe treatment option in patients with psoriasis who failed secukinumab.…”

Section: Demographics and Characteristics Of Secukinumab Nonrespondersupporting

confidence: 50%

Efficacy and safety of switching to ixekizumab in secukinumab nonresponder patients with psoriasis: results from a multicentre experience

et al. 2019

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“…In this sense, a recent study by Georgakopoulos et al . showed that a large proportion of secukinumab non‐responders (22/31; 71.0%) who switch to ixekizumab could experience an improved clinical response regardless of the reason or timing of secukinumab discontinuation . Furthermore, the authors observed that not all patients who experience an AE with secukinumab will experience the same event with ixekizumab.…”

Section: Discussionmentioning

confidence: 99%

Initial results of ixekizumab efficacy and safety in real‐world plaque psoriasis patients: a multicentre retrospective study

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López‐Ferrer

et al. 2018

Acad Dermatol Venereol

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Background Ixekizumab (anti‐IL17A) is effective as treatment for moderate‐to‐severe plaque psoriasis, but real‐life data on effectiveness and safety are currently very limited. Objective To evaluate the efficacy and safety of ixekizumab in a cohort of real‐life plaque psoriasis patients. Methods Retrospective chart review of 100 patients with moderate‐to‐severe plaque psoriasis treated with ixekizumab at seven Spanish dermatological centres. Results According to the as observed analysis, the percentage of patients achieving a 75% and 90% of reduction from the baseline score of Psoriasis Area and Severity Index (PASI) was 87.5%–50.0% at week 12–16; 88.3%–58.4% at week 24 and 82.9%–58.5% at week 52, respectively. The mean ± standard deviation (SD) score of PASI at baseline was 12.9 ± 9.2, and it declined rapidly after ixekizumab administration to 1.9 ± 4.0 (P < 0.001) at week 12–16 and was maintained at 1.7 ± 4.1 and 1.8 ± 2.9 at week 24 and 52, respectively. Ixekizumab response was not affected by clinical variables like body mass index, disease duration or the presence of psoriatic arthritis. However, the bio‐naive group showed significantly higher PASI 75 response rate at week 12–16 compared to patients previously exposed to biologic agents (P = 0.037). Twenty‐six (26%) patients experienced adverse events (AEs) during the follow‐up period, being most of them of mild‐to‐moderate intensity. The most common AE was local reaction at the site of injection (14/26; 53.8%). At the end of the observational period, 15 (15%) patients discontinued ixekizumab treatment due to limited clinical improvement (n = 11), adverse events (n = 3) or lost to follow‐up (n = 1) within a mean ± SD time of 6.0 ± 3.9 months. Conclusion The present study illustrates the initial experience with ixekizumab in real‐world clinical practice confirming its usefulness and safety in the management of plaque psoriasis patients.

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Efficacy and safety of switching to ixekizumab in secukinumab nonresponders with plaque psoriasis: A multicenter retrospective study of interleukin 17A antagonist therapies

Cited by 45 publications

References 5 publications

Switching from Secukinumab to Ustekinumab in Psoriasis Patients: Results from a Multicenter Experience

Switching from Secukinumab to Ustekinumab in Psoriasis Patients: Results from a Multicenter Experience

Efficacy and safety of switching to ixekizumab in secukinumab nonresponder patients with psoriasis: results from a multicentre experience

Initial results of ixekizumab efficacy and safety in real‐world plaque psoriasis patients: a multicentre retrospective study

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