Psoriasis: ixekizumab bests ustekinumab in year-long IXORA-S phase 3

  • Paul C & al.
  • J Am Acad Dermatol
  • 30 Jun 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Results from the IXORA-S phase 3 trial suggest that ixekizumab (Taltz) has superior efficacy compared with ustekinumab (Stelara) over the course of 52 weeks in patients with plaque psoriasis.

Why this matters

  • IXORA-S is the first head-to-head trial providing 52-week comparative data between 2 biologics targeting the IL-23/IL-17 pathway.

Key results

  • Ixekizumab was associated with superior rates of ≥90% improvement in Psoriasis Area and Severity Index (PASI90) (76.5% vs 59.0%), PASI100 (52.2% vs 35.5%), static physician global assessment (sPGA) 0 (52.9% vs 36.1%), and sPGA 0/1 (82.1% vs 65.1%) at 52 weeks compared with ustekinumab (P<.01 for all>
  • Ixekizumab and ustekinumab were associated with similar rates of treatment-emergent adverse events (AEs) (86.7% vs 83.7%; P=.519), serious AEs (6.7% vs 3.6%; P=.289), and discontinuation (2.2% vs 1.2%; P=.660).
  • Ixekizumab patients had a higher rate of injection site reactions (16.3% vs 1.2%; P<.001 compared with ustekinumab patients.>

Study design

  • 302 patients with plaque psoriasis (136 treated with ixekizumab; 166 treated with ustekinumab) were analyzed for efficacy and safety outcomes at 52 weeks.
  • Funding: Eli Lilly and Company.

Limitations

  • Study was not designed to compare safety endpoints related to rare events.

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