Psoriasis Treatment Ixekizumab Safe for Cardiovascular Health

According to results of a combined analysis of 3 randomized, double-blind, placebo-controlled phase 3 clinical trials, published in the Journal of the American Academy of Dermatology, treatment of psoriasis with ixekizumab yields no significant effects on cardiovascular parameters.

Both psoriasis and atherosclerosis are held to have similar underlying pathogeneses. Consequently, biologic therapies for psoriasis may have an impact on cardiovascular parameters, potentially resulting in major adverse cardiovascular events. 

Ixekizumab, a monoclonal antibody targeting interleukin-17A, is an effective treatment for moderate to severe psoriasis. The aim of this study was to investigate its impact on cardiovascular parameters. 

Investigators analyzed data from 3 phase 3 clinical trials, UNCOVER-1, -2, and -3. Adult patients with moderate to severe psoriasis were randomly assigned to 1 of 4 groups: placebo, 80 mg of ixekizumab every 4 weeks, 80 mg of ixekizumab every 2 weeks (UNCOVER-1/-2/-3), or 50 mg etanercept biweekly (UNCOVER-2/-3 only). Patients in the ixekizumab groups received a starting dose of 160 mg. Each drug was administered from weeks 0 to 12 for the induction period. 

Patients whose disease responded to ixekizumab treatment were then re-randomized for the maintenance period (weeks 12-60) to 1 of 3 groups: placebo, 80 mg ixekizumab every 4 weeks, or 80 mg ixekizumab every 12 weeks (UNCOVER-2/-3 only), although only data from the first 2 groups were analyzed. Through the entire 60 weeks of the study, the following parameters were assessed: fasting lipid profiles, glucose, high-sensitivity C-reactive protein, weight, blood pressure, and electrocardiogram. 

The parameters were within normal limits at baseline across groups, except triglycerides and high-sensitivity C-reactive protein. By 60 weeks, no significant changes were shown in the ixekizumab group vs placebo for any of the parameters. Importantly, the low-density lipoprotein/high-density lipoprotein ratio remained stable throughout the study.

Although the study was limited by the lack of echocardiogram assessments, the authors were able to conclude that ixekizumab does not have a significant impact on cardiovascular parameters. Therefore, clinicians should treat patients receiving ixekizumab with any necessary medications or interventions for cardiovascular-related concerns.

Disclosures: Funding for the study was provided by Eli Lilly and Company. Several authors declare affiliations with the pharmaceutical industry. 

Reference

Egeberg A, Wu JJ, Korman N, et al. Ixekizumab treatment shows a neutral impact on cardiovascular parameters in patients with moderate-to-severe plaque psoriasis: results from UNCOVER-1, -2, and -3 [published online March 13, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.02.074