J Drugs Dermatol. 2024 Aug 1;23(8):619-625. doi: 10.36849/JDD.8160.
Psoriasis involving challenging body areas, such as the scalp, face, palmoplantar surfaces, or nails, can be challenging to treat and negatively affects patient outcomes.
To assess clear responses and cumulative clinical benefits over 5 years of ixekizumab treatment of moderate-to-severe plaque psoriasis in patients with and without baseline involvement of challenging body areas.
This post hoc analysis included patients treated with ixekizumab in the UNCOVER-3 trial. We assessed PASI100 responses through the week (W) 264 and cumulative clinical benefits at W264 (calculated as least-squares mean of the percentage of maximum area under the curve for PASI100 and PASI% improvement and expressed as cumulative clearance days). Statistical differences were calculated via ANCOVA.
A total of 385 patients were analyzed: 349 with scalp involvement, 152 with facial involvement, 96 with palmoplantar involvement, and 229 with nail involvement. Proportions of patients achieving PASI100 were numerically similar between patients with and without scalp and nail involvement. More patients without facial and palmoplantar involvement achieved PASI100 at W60 (only palmoplantar), W108, W156, W204, and W264 (only palmoplantar). At W264, cumulative clinical benefits for PASI100 and PASI% improvement were high and similar in both patient groups, with and without challenging body areas. A significant difference (P=0.006) was only observed for PASI% improvement between patients with and without nail involvement.
For most efficacy measures, patients treated with ixekizumab over 5 years achieved similar clear responses and cumulative clinical benefits regardless of baseline involvement of challenging body areas. J Drugs Dermatol. 2024;23(8):619-625. doi:10.36849/JDD.8160.
头皮、面部、手掌和足底或指甲等挑战性身体部位受累的银屑病可能难以治疗，并对患者结局产生负面影响。
评估依奇珠单抗治疗中重度斑块状银屑病患者在基线是否存在挑战性身体部位受累情况下，5 年内达到清除（定义为 PASI100）应答和累积临床获益的情况。
这项事后分析纳入了 UNCOVER-3 试验中接受依奇珠单抗治疗的患者。我们在第 264 周评估 PASI100 应答情况，在第 264 周评估累积临床获益情况（计算方法为 PASI100 和 PASI%改善的最大曲线下面积的最小二乘均值，并用累积清除天数表示）。采用协方差分析（ANCOVA）计算统计学差异。
共分析了 385 例患者：349 例头皮受累，152 例面部受累，96 例手掌和足底受累，229 例指甲受累。头皮和指甲受累患者达到 PASI100 的比例在数值上相似。无面部和手掌足底受累的患者在第 60 周（仅手掌足底）、第 108 周、第 156 周、第 204 周和第 264 周（仅手掌足底）时达到 PASI100 的比例更高。在第 264 周时，PASI100 和 PASI%改善的累积临床获益均较高，且两组患者（有或无挑战性身体部位受累）相似。仅在指甲受累患者中观察到 PASI%改善的差异有统计学意义（P=0.006）。
对于大多数疗效指标，接受依奇珠单抗治疗 5 年的患者在基线是否存在挑战性身体部位受累的情况下，均能达到相似的清除应答和累积临床获益。
