Plaque Psoriasis: Secukinumab Beats Ustekinumab in a Head-to Head Clinical Trial & Ixekizumab Helps Improve Productivity

Secukinumab vs. Ustekinumab for Plaque Psoriasis
In a 52-week clinical trial, secukinumab proved superior to ustekinumab for sustained skin clearance in adults with moderate to severe plaque psoriasis.¹ More patients treated with secukinumab achieved a greater than 90% Psoriasis Area and Severity Index (PASI) score than those treated with ustekinumab. The secukinumab PASI 90 response was 76% and the ustekinumab PASI 90 response was 61%. At Week 52, PASI 100 (clear skin) response was also significantly better for secukinumab-treated patients compared with ustekinumab-treated patients (46% vs. 36%).

Additionally, significantly greater and sustained Dermatology Life Quality Index responses were obtained for secukinumab-treated patients compared with ustekinumab-treated patients (72% vs. 59%). Half of secukinumab-treated patients achieved PASI 75 at Week 4 of the study (50% vs. 21%, P<0.0001).

Secukinumab is a fully human interleukin-17A inhibitor that is U.S. Food and Drug Administration approved to treat moderate to severe plaque psoriasis, psoriatic arthritis and ankylosing spondylitis.

Ixekizumab Improves Productivity in Patients with Plaque Psoriasis
Ixekizumab, an IgG4 monoclonal antibody, selectively binds with the interleukin-17A (IL-17A) cytokine, inhibiting its interaction with the IL-17 receptor and inhibiting the release of pro-inflammatory cytokines and chemokines. The treatment is being investigated to treat moderate to severe plaque psoriasis and active psoriatic arthritis.

The results of three pivotal Phase 3 trials that evaluated work productivity in patients with moderate to severe plaque psoriasis receiving ixekizumab every two weeks were recently reported. These studies are UNCOVER-1, UNCOVER-2 and UNCOVER-3.²

Work productivity, evaluated by the change from baseline as measured by Work Productivity and Activity Impairment-Psoriasis (WPAI-PSO) scores, were evaluated at Week 12 of the studies. Compared with placebo-treated patients, all ixekizumab-treated patients reported improved work productivity. Additionally, in the UNCOVER-1 study, these work productivity improvements were sustained up to 60 weeks in patients who had a clinical response to ixekizumab at Week 12. Also, in UNCOVER-1 and UNCOVER-3, ixekizumab-treated patients had significantly greater improvement in all WPAI-PSO scores (e.g., absenteeism, presenteeism, work productivity loss and activity impairment [P<0.001 for all]) compared with placebo-treated patients. In the UNCOVER-2 study, ixekizumab-treated patients compared with placebo-treated patients showed significantly greater improvement in all WPAI-PSO scores: absenteeism (P=0.016), presenteeism (P<0.001), work productivity loss (P<0.001) and activity impairment (P<0.001).

When ixekizumab-treated patients were compared with etanercept-treated patients, ixekizumab-treated patients also showed significantly greater improvement in WPAI scores for presenteeism, work productivity loss and activity impairment (P< 0.001 for all).

Treatment-emergent adverse events were mild or moderate, with the most common being reported as injection-site reactions and upper respiratory tract infections, most frequently nasopharyngitis.

Michele B. Kaufman, PharmD, CGP, RPh, is a freelance medical writer based in New York City and a pharmacist at New York Presbyterian Lower Manhattan Hospital.

References

1. Novartis. News release: Novartis’ cosentyx superior to stelara in delivering long-lasting skin clearance (PASI 90) for psoriasis patients at 52 weeks. 2016 Mar 5.
2. Eli Lilly and Co. News release: Studies show ixekizumab improved work productivity for patients with moderate to severe plaque psoriasis: Results published in JAMA Dermatology. 2016 Mar 7.