Ixekizumab demonstrates sustained efficacy in treating moderate to severe psoriasis in challenging body areas over a 5-year period, according to a recent study. The research, a post-hoc analysis of the UNCOVER-3 clinical trial, showed that patients treated with ixekizumab experienced similar clearance responses and cumulative clinical benefits regardless of baseline involvement of areas such as the scalp, face, palms, soles, and nails.
Alice B. Gottlieb, MD, PhD, from the Icahn School of Medicine at Mount Sinai, and colleagues noted that psoriasis in these challenging areas is often associated with higher disease severity and can be difficult to treat. The study aimed to assess the long-term effectiveness of ixekizumab in these specific locations.
The UNCOVER-3 trial was a randomized, double-blind, placebo-controlled, active-controlled phase 3 study. Patients were initially assigned to receive either placebo, 50 mg etanercept, or a 160 mg loading dose of ixekizumab followed by 80 mg every 2 or 4 weeks for 12 weeks. In the long-term extension, all patients received ixekizumab through week 264.
The post-hoc analysis included data from 385 patients, with 349 having scalp involvement, 152 facial involvement, 96 palmoplantar involvement, and 229 nail involvement. PASI 100 achievement was similar among patients with and without scalp and nail involvement. However, a higher percentage of patients without facial or palmoplantar involvement achieved PASI 100 at week 264 (69.4% vs. 62.7% for facial involvement; 70.6% vs 51.2% for palmoplantar involvement).
Cumulative Clinical Benefits
Cumulative clinic benefits at week 264 were generally similar between those with and without challenging body area involvement. Notably, nail involvement showed a statistically significant difference in cumulative days of clinical benefit for PASI percentage improvement (1,678.9 days with involvement vs. 1,554.1 days without involvement; P = .006).
Expert Commentary
The authors concluded that ixekizumab provides consistent and durable efficacy in treating psoriasis, even in areas that are typically difficult to manage. The findings suggest that ixekizumab can be a valuable long-term treatment option for patients with moderate to severe plaque psoriasis, regardless of the presence of challenging body area involvement.
