In patients with moderate to severe plaque psoriasis, treatment with ixekizumab was associated with higher drug survival than treatment with secukinumab, according to a study published in the Journal of the American Academy of Dermatology. The findings were intriguing in that patients treated with secukinumab were typically treated with fewer biologics compared with patients treated with ixekizumab prior to starting their respective therapy.

Using the DERMBIO quality assurance database, researchers obtained data of Danish patients with moderate to severe plaque psoriasis and included these data in a drug survival analysis. Only patients who received either ixekizumab (n=62) or secukinumab (n=368) were enrolled. Drug survival for secukinumab and ixekizumab at 12 months served as the primary outcome. Secondary outcome was drug survival of secukinumab at 3 years.

A greater proportion of patients who received secukinumab had been treated with fewer biologic therapies prior to starting the study drug compared with patients who received ixekizumab (40.7% vs 12.9%, respectively). The mean number of prior biologics was higher for patients treated with secukinumab vs patients treated with ixekizumab (1.3 vs 3.6, respectively; P <.0001). During a 12-month period, 23.5% of patients who had not previously received biologic drugs discontinued secukinumab, with the majority of these patients discontinuing therapy within the first 6 months (68.8%). Overall, drug survival was lower for patients who were treated with secukinumab. During a 3-year follow-up, drug survival for secukinumab was lowest in patients who had been treated with ≥2 biologics; patients who were treated with secukinumab as a second biologic therapy demonstrated a higher drug survival.

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Limitations of the analysis include the small number of patients as well as the relatively short follow-up period.

While the differences in survival between the drugs remain unclear, the researchers suggest these “differences in their binding affinity to [interleukin]-17 may at least in part explain these findings.”

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Reference

Egeberg A, Bryld LE, Skov L. Drug survival of secukinumab and ixekizumab for moderate-to-severe plaque psoriasis [published online June 3, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.05.082