Ruiz-Villaverde Ricardo, Ezomo-Gervilla Pedro José, Molina-Espinosa Jose, Galán-Gutierrez Manuel, Herrera-Acosta Enrique, Suarez-Perez Jorge Alonso
Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain, Spain Biohealth Research Institute in Granada (ibs.GRANADA), 18006 Granada, Spain.
Department of Dermatology, Hospital Universitario San Reina Sofía, IMIBIC, 14004 Córdoba, Spain.
J Clin Med. 2025 Jan 27;14(3):833. doi: 10.3390/jcm14030833.
Ixekizumab, an IL-17A inhibitor, is an effective treatment for moderate-to-severe plaque psoriasis. Although clinical trials support the use of an induction phase for optimal results, real-world evidence comparing induction versus maintenance-only regimens is limited. This study assessed the real-world effectiveness, safety, and drug survival of ixekizumab with and without an induction phase in patients with moderate-to-severe plaque psoriasis. A multicenter, observational study was conducted with 183 patients treated with ixekizumab over five years at tertiary hospitals in Andalucía, Spain. Patients were divided into two groups: an induction group (160 mg at baseline, followed by 80 mg at weeks 2, 4, 6, 8, 10, and 12, then every 4 weeks) and a non-induction group (80 mg every 4 weeks from initiation). Baseline characteristics, clinical outcomes (PASI [Psoriasis Activity Skin Index] and PGA [Physician Global Assessment] scores), and drug survival were analyzed. The majority of patients were male (64.48% in the induction group, 58.74% in the non-induction group). No significant differences were found in age or BMI [body mass index] between groups. Baseline PASI and PGA scores were higher in the induction group, reflecting greater initial disease severity. Both regimens achieved significant clinical improvements, though the induction group demonstrated faster initial responses. Drug survival was lower in the induction group ( = 0.0033), potentially due to the higher baseline disease burden and severity in these patients. Comorbidities, including metabolic syndrome, cardiovascular risks, and psychiatric conditions, were prevalent, particularly in the induction group. Ixekizumab is effective for moderate-to-severe plaque psoriasis, with induction therapy yielding faster responses. However, lower drug survival in the induction group highlights the influence of initial disease severity on long-term outcomes. Real-world findings support the flexibility of ixekizumab across diverse patient populations, though further research is warranted.
司库奇尤单抗是一种白细胞介素-17A抑制剂，是治疗中重度斑块状银屑病的有效药物。尽管临床试验支持采用诱导期治疗以获得最佳疗效，但比较诱导期与仅维持治疗方案的真实世界证据有限。本研究评估了司库奇尤单抗在有或无诱导期的中重度斑块状银屑病患者中的真实世界有效性、安全性和药物留存率。在西班牙安达卢西亚的三级医院对183例接受司库奇尤单抗治疗五年的患者进行了一项多中心观察性研究。患者分为两组：诱导组（基线时160mg，随后在第2、4、6、8、10和12周时80mg，然后每4周一次）和非诱导组（从开始治疗每4周80mg）。分析了基线特征、临床结局（银屑病皮损面积和严重程度指数[PASI]和医生整体评估[PGA]评分）以及药物留存率。大多数患者为男性（诱导组为64.48%，非诱导组为58.74%）。两组间年龄或体重指数[BMI]无显著差异。诱导组的基线PASI和PGA评分较高，反映出初始疾病严重程度更高。两种治疗方案均取得了显著的临床改善，尽管诱导组的初始反应更快。诱导组的药物留存率较低（P = 0.0033），可能是由于这些患者的基线疾病负担和严重程度较高。包括代谢综合征、心血管风险和精神疾病在内的合并症很常见，尤其是在诱导组。司库奇尤单抗对中重度斑块状银屑病有效，诱导治疗反应更快。然而，诱导组较低的药物留存率凸显了初始疾病严重程度对长期结局的影响。真实世界的研究结果支持司库奇尤单抗在不同患者群体中的灵活性，尽管仍需进一步研究。
