Sherman Shany, Zloczower Ory, Noyman Yehonatan, Amitay-Laish Iris, Hodak Emmilia, Pavlovsky Lev
Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva 4941492, Israel.
Acta Derm Venereol. 2020 Dec 14;100(19):adv00349. doi: 10.2340/00015555-3714.
The long-term effect of intra-anti-interleukin-17-class switch on drug survival is unclear. The aim of this study was to evaluate the efficacy and long-term survival of ixekizumab in bio-experienced psoriatic patients with and without previous exposure to anti-interleukin-17 treatment. Retrospective search of a tertiary medical centre database for 2017 to 2019 yielded 73 patients treated with ixekizumab: 50 previously exposed to secukinumab and 23 anti-interleukin-17-naïve. Median baseline Psoriasis Area Severity Index (PASI) was 23.0. Median number of received biologics was 4. Mean drug survival was 16.4 and 16.8 months in the anti-interleukin-17-exposed and naïve groups, respectively (p = 0.878). There was no between-group difference in proportion of patients achieving ≥ 75 PASI response. At study end, 25 anti-interleukin-17-exposed patients (50.0%) and 17 anti-interleukin-17-naïve patients (73.9%) were still on ixekizumab. The use of multiple previous biologic treatments was associated with substantially reduced ixekizumab survival. In conclusion, previous anti-interleukin-17-exposure was associated with an initially favourable response and did not further reduce ixekizumab survival.
抗白细胞介素-17类别转换对药物留存的长期影响尚不清楚。本研究的目的是评估司库奇尤单抗在有或无抗白细胞介素-17治疗史的生物制剂治疗经验丰富的银屑病患者中的疗效和长期留存情况。对一家三级医疗中心2017年至2019年数据库进行回顾性检索，筛选出73例接受司库奇尤单抗治疗的患者：50例曾接受过司库奇尤单抗治疗，23例未接受过抗白细胞介素-17治疗。银屑病面积和严重程度指数（PASI）基线中位数为23.0。接受生物制剂的中位数为4种。抗白细胞介素-17治疗组和未治疗组的平均药物留存时间分别为16.4个月和16.8个月（p = 0.878）。达到PASI改善≥75%的患者比例在两组之间无差异。在研究结束时，25例接受过抗白细胞介素-17治疗的患者（50.0%）和17例未接受过抗白细胞介素-17治疗的患者（73.9%）仍在使用司库奇尤单抗。既往使用多种生物制剂治疗与司库奇尤单抗留存率显著降低相关。总之，既往接受过抗白细胞介素-17治疗与初始良好反应相关，且未进一步降低司库奇尤单抗的留存率。
