In moderate to severe plaque psoriasis, patients treated with ixekizumab tend to stay on the drug longer than those treated with secukinumab, according to a study published in the Journal of the American Academy of Dermatology.

Researchers followed the drug survival of these 2 biologics targeting interleukin-17, to observe how long patients stayed on medication over a 12-month period before discontinuing treatment.

For this nationwide cohort, the researchers assessed data from Dermbio, the Danish Biologic Interventions Registry. In this registry, Danish dermatologists are required to record all biologic treatments they prescribe to patients with psoriasis. In the 12-month period studied, 368 patients received treatment with secukinumab and 62 with ixekizumab with standard in-label dosing.

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Of the 368 patients who received treatment with secukinumab, 40.7% were bio-naïve. Over 12 months, 23.5% of these bio-naive patients discontinued therapy. Over an extended 3-year follow-up, the patients previously prescribed 2 or more biologics were least likely to persist with their secukinumab treatment, followed by patients previously prescribed 1 other biologic.

In the group of 62 patients who received treatment with ixekizumab, 12.9% were bio-naive. Over the 12-month period studied, none of these bio-naive patients discontinued therapy.

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Although this is the largest cohort study published on the topic, the main limitation of this study is its modest size. The size of the ixekizumab-treated group, in particular, is smaller than desired, especially in comparison with the secukinumab-treated group.

The researchers suggest that a factor in ixekizumab’s high survival rate could be its high affinity for interleukin-17, but this possibility was not explored in this study.

The group concludes, “drug survival was higher for ixekizumab […] even though secukinumab-treated patients had been treated with significantly fewer biologics prior to starting this drug.” They remark that the findings regarding secukinumab’s low drug survival rate are consistent with those of previous studies but that further exploration is desirable.

Disclosure: Alexander Egeberg, MD, PhD, and Lone Skov, MD, PhD, DMSc, have declared associations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Egeberg A, Bryld LE, Skov L. Drug survival of secukinumab and ixekizumab for moderate-to-severe plaque psoriasis [published online March 23, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.03.048