Wednesday, 20 Nov 2019

You are here

Ixekizumab vs. Adalimumab in Psoriatic Arthritis

The Annals of Rheumatic Disease reports a psoriatic arthritis study where in ixekizumab was non-inferior to adalimumab for achievement of ACR50 responses but was superior to adalimumab for achievement of PASI100 by week 24.

The study aimed to compare ixekizumab (IXE) to adalimumab (ADA) in biological disease-modifying antirheumatic drug-naïve patients with both active psoriatic arthritis (PsA) and psoriatic skin disease after and inadequate response to conventional synthetic disease-modifying antirheumatic drug (csDMARDs).

The 12 month study included 566 active PsA patients who were randomised (1:1) to either IXE or ADA in an open-label, head-to-head, blinded assessor clinical trial. The primary endpoint was a composite 6 mos. response measured by the ACR50 and a PASI100 - 100% improvement from baseline in the Psoriasis Area and Severity Index. 

The primary endpoint favored IXE (36%) over ADA (28%; p=0.036).  The difference was largely driven by skin superiority for IXE, as the ACR50 responses were similar (IXE: 51%, ADA: 47%), but the PASI100 responses favored IXE (IXE: 60%, ADA: 47%; p=0.001). IXE had greater response versus ADA in other secondary outcomes for PsA, including skin, nail, treat-to-target and quality-of-life outcomes. Serious adverse events were reported in 8.5% (ADA) and 3.5% (IXE) of patients.

IXE was superior to ADA in achievement of superior skin responses and equivalent to ADA in ACR50 outcomes. 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

Add new comment

More Like This

New Treatments in Axial SpA from #ACR2019

There were new developments in the treatment of axial Spondyloarthritis (AS) at ACR 2019. The first area is on the use of anti-IL17A drugs, secukinumab and ixekizumab in non-radiographic AS. The second area is the use of JAK-1 inhibitor Upadacitinib in radiographic AS. The third area is the use of dual anti-IL17A and 17F drug bimekizumab in radiographic.

Most Psoriatics Go on Biologics

A cohort study of 97 patients with psoriatic arthritis (PsA) examined the prescribing practices in PsA, and found biologics are commonly initiated as the primary mode of therapy in outpatients with PsA. However, treatment modifications can be made regarding patients who are managed with apremilast alone.

Year in Review - Psoriatic Arthritis 2019

Major new insights into the treatment of psoriatic arthritis dominated the headlines during the past year, with a head-to-head trial comparing IL-17A inhibition with tumor necrosis factor blockade, another study considering whether methotrexate can improve outcomes with anti-TNF therapy in PsA, and an investigation into the effects of biologic therapy on bone.

EXCEED Study: Cosentyx Equals Humira in Psoriatic Arthritis

Novartis has announced the results of the EXCEED trial that pitted its IL-17 inhibitor, Cosentyx (secukinumab - SEC) against Humira (adalimumab - ADA) in patients with active psoriatic arthritis. The trial demonstrated that SEC was not non-inferior to ADA, but failed to meet its primary endpoint of superiority over ADA as far as drug efficacy.

Rinvoq (upadacitinib) Effective in Psoriatic Arthritis

Yesterday, AbbVie reported the top-line study results showing the efficacy of Rinvoq (upadacitinib - UPAD) adult patients with active psoriatic arthritis who previously had an inadequate response to a biologic DMARD.