Egeberg Alexander, Hawkes Jason E, Somani Najwa, Burge Russel, See Kyoungah, Gallo Gaia, McKean-Matthews Missy, Gooderham Melinda, Han George, Armstrong April
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Dermatol Ther (Heidelb). 2024 Apr;14(4):1007-1018. doi: 10.1007/s13555-024-01147-7. Epub 2024 Apr 22.
Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin-17A, is approved for the treatment of moderate-to-severe plaque psoriasis. Since scalp psoriasis can be burdensome and challenging to treat with non-systemic therapies, this post hoc analysis focused on scalp psoriasis in patients with moderate-to-severe plaque psoriasis and baseline scalp involvement. The analysis considered a holistic concept of clearance through 5 years of ixekizumab treatment.
Ixekizumab-treated patients with baseline scalp involvement were pooled from three multicenter, randomized, double-blind, placebo-controlled, phase 3 trials (integrated UNCOVER-1/2 and UNCOVER-3). Analyses were performed on a subpopulation of patients who achieved complete resolution of scalp psoriasis at Week 60 (i.e., Week 60 Psoriasis Scalp Severity Index [PSSI-0] responders) and on the overall patient population (i.e., Week 60 PSSI-0 responders and non-responders), which was used as a reference. Clinical outcomes (PSSI), patient-reported outcomes (Itch Numeric Rating Scale [NRS] score, Skin Pain Visual Analogue Scale [VAS]), quality of life (Dermatology Life Quality Index [DLQI]), and concurrent outcomes were assessed from baseline through 5 years. Descriptive statistics of observed data were reported.
After 60 weeks of ixekizumab treatment, 88.4% (UNCOVER-1/2) and 75.9% (UNCOVER-3) of patients with baseline scalp involvement achieved complete clearance (PSSI-0) of scalp psoriasis. Substantial improvements in the clinical outcomes (PSSI), patient-reported outcomes (Itch NRS, Skin Pain VAS), and quality of life (DLQI) were achieved by Week 60 and sustained through Week 264 in the Week 60 PSSI-0 responders and in the overall patient population. Additionally, a significant proportion of Week 60 PSSI-0 responders achieved concurrent complete scalp and skin clearance and quality of life improvement through 5 years.
Continued treatment with ixekizumab provided long-term sustained scalp clearance over 5 years to patients with moderate-to-severe plaque psoriasis and baseline scalp involvement, and holistic improvements occurred across clinical outcomes, patient-reported outcomes, and quality of life.
NCT01474512 (UNCOVER-1), NCT01597245 (UNCOVER-2), and NCT01646177 (UNCOVER-3).
ixekizumab是一种高亲和力单克隆抗体,可选择性靶向白细胞介素-17A,已被批准用于治疗中度至重度斑块状银屑病。由于头皮银屑病使用非系统性疗法治疗可能较为棘手且具有挑战性,因此这项事后分析聚焦于中度至重度斑块状银屑病且基线时头皮受累的患者的头皮银屑病。该分析考虑了通过5年的ixekizumab治疗实现清除的整体概念。
将来自三项多中心、随机、双盲、安慰剂对照的3期试验(整合的UNCOVER-1/2和UNCOVER-3)中基线时头皮受累且接受ixekizumab治疗的患者汇集在一起。对在第60周实现头皮银屑病完全消退的患者亚组(即第60周银屑病头皮严重程度指数[PSSI-0]应答者)以及整体患者群体(即第60周PSSI-0应答者和非应答者)进行分析,整体患者群体用作对照。从基线到5年评估临床结局(PSSI)、患者报告结局(瘙痒数字评定量表[NRS]评分、皮肤疼痛视觉模拟量表[VAS])、生活质量(皮肤病生活质量指数[DLQI])以及并发结局。报告观察数据的描述性统计。
ixekizumab治疗60周后,基线时头皮受累的患者中,88.4%(UNCOVER-1/2)和75.9%(UNCOVER-3)实现了头皮银屑病的完全清除(PSSI-0)。在第60周PSSI-0应答者和整体患者群体中,到第60周临床结局(PSSI)、患者报告结局(瘙痒NRS、皮肤疼痛VAS)和生活质量(DLQI)均有显著改善,并持续至第264周。此外,相当比例的第60周PSSI-0应答者在5年期间实现了头皮和皮肤的同时完全清除以及生活质量改善。
对于中度至重度斑块状银屑病且基线时头皮受累的患者,持续使用ixekizumab进行治疗可在5年期间实现长期持续的头皮清除,并且在临床结局、患者报告结局和生活质量方面均有整体改善。
NCT01474512(UNCOVER-1)、NCT01597245(UNCOVER-2)和NCT01646177(UNCOVER-3)。