Ustekinumab, Secukinumab, and Ixekizumab Comparable for Plaque Psoriasis

plaque psoriasis
Psoriasis vulgaris on the male hand and finger nails with plaque, rash and patches, isolated on white background. Autoimmune genetic disease.
Ustekinumab, secukinumab, and ixekizumab were compared for clinical effectiveness and associated adverse events in the treatment of plaque psoriasis.

Ustekinumab, secukinumab, and ixekizumab have comparable efficacy and safety in treating moderate to severe plaque psoriasis, according to study findings published in the Journal of the European Academy of Dermatology and Venereology.

In the multicenter, retrospective chart review, researchers identified 180 patients aged ≥18 years with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index [PASI≥10]) from 2 tertiary academic hospitals in Toronto, Canada, from  January 2014 to January 2018 (n=180). Patients were treated with ustekinumab (n=60), secukinumab (n=60), and ixekizumab (n=60). Treatment failure was defined as lack of efficacy, intolerance, or other non-drug-related reason. PASI 75 and PASI 100 at 12 weeks were the clinically significant efficacy endpoints.

At week 12, there were no significant differences in PASI response rates between ustekinumab (73.3%; P =.851), secukinumab (76.7%; P =.389), and ixekizumab (75.0%; P =.574). Compared with ustekinumab and secukinumab, ixekizumab was associated with a significantly higher incidence of adverse events (AEs) (P =.001). Reported infections were mild in nature, either self-resolving or treated with a short course of antibiotic/antifungal agents. There were no clinically significant differences between treatment groups in the rates of discontinuation due to lack of efficacy or AEs.

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“These results contrast existing clinical trial data showing that secukinumab and ixekizumab demonstrate superiority in PASI 75/100 or PGA 0 response at week 12 to ustekinumab,” the researchers concluded. “Our results highlight the potential limitations of [randomized control trials’] generalizability and how effectiveness and AE of each biologic may be dependent on variations in clinical characteristics including comorbidities and prior biologic exposure.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Georgakopoulos JR, Lam K, Sandhu VK, et al. Comparative 12-week effectiveness and safety outcomes of biologic agents ustekinumab, secukinumab and ixekizumab for the treatment of plaque psoriasis: a real-world multicenter retrospective study [published online March 16, 2020]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16366