Ixekizumab achieved higher Psoriasis Area Severity Index (PASI) than ustekinumab in patients with moderate to severe psoriasis and a body mass index (BMI) greater than 27, according to results of a retrospective observational study published in Dermatology Therapy.

To compare the effectiveness and safety of ustekinumab and ixekizumab in the treatment of moderate to severe plaque psoriasis outside clinical trials, data from 64 patients were analyzed. At baseline, there was a significant difference between patients in the ustekinumab and ixekizumab groups regarding age (P =.042), sex (P =.02), and BMI (P =.002). A total of 28.6% of patients in the ixekizumab group had previously been treated with ustekinumab.

After 52 weeks, no significant difference in effectiveness was observed between the 2 groups. A PASI 100 response was achieved in 40% of the ixekizumab group, whereas 25% of the ustekinumab group achieved this score. For patients with a previous biological failure, a PASI 100 response was achieved by 36.4% of the ixekizumab group and 17.6% of the ustekinumab group. Although these results were not significant, the PASI response 90 for individuals with BMI greater than 27 was significantly higher for patients in the ixekizumab group (P =.024). Ustekinumab had a survival rate of 96.4% compared with a survival rate of 80% for ixekizumab, bordering on significance (P =.052).

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Limitations to this study include its small sample size and retrospective nature.

The results of this study indicated that ixekizumab and ustekinumab are similarly effective in treating moderate to severe psoriasis in a real-world environment. The investigators allow that this may be affected by the tendency to prescribe ixekizumab for patients who are more difficult to treat. Ixekizumab may be the treatment of choice for those who are slightly overweight, they suggested.


Herrera-Acosta E, Garriga-Martinan GG, Suárez-Pérez, Martínez-García E, Herrera-Ceballos E. Ixekizumab versus ustekinumab for skin clearance in patients with moderate to severe psoriasis after a year of treatment: real-world practice. [published online August 18, 2020]. Dermatol Ther. doi:10.1111/dth.14202