Ixekizumab efficacious in PsA following one or two inadequate anti-TNF responses
medwireNews: Patients with psoriatic arthritis (PsA) who have an inadequate response to one or two tumor necrosis factor (TNF) inhibitors may benefit from ixekizumab, suggests research presented at the EULAR 2019 congress in Madrid, Spain.
“This patient population generally represents a particular challenge for clinicians, so it may be helpful to understand how patients respond to other treatment mechanisms following inadequate response to TNF inhibitors,” Amanda Gellett (Eli Lilly and Company, Indianapolis, Indiana, USA) explained to delegates.
Building on the findings of the SPIRIT-P2 trial, previously reported by medwireNews, that showed the promise of the interleukin-17a inhibitor in treating PsA in patients with an inadequate response to TNF inhibitors, the current post-hoc analysis suggests that this is true regardless of whether one or two TNF inhibitors have been tried.
Specifically, Gellett reported an ACR50 response rate at 24 weeks of 33.8% among 71 patients taking ixekizumab 80 mg every 4 weeks after failing to adequately respond to one TNF inhibitor compared with 2.9% among 68 patients assigned to placebo. The rate was similar, at 36.6%, among 41 patients receiving the same ixekizumab regimen after an inadequate response to two TNF inhibitors versus 7.3% among 41 placebo-treated patients.
Gellett presented further significant benefits with ixekizumab over placebo in terms of the proportion of patients achieving at least a 0.35-point improvement in HAQ-DI score at week 24, at 45.9% and 44.4% of ixekizumab-treated patients with inadequate responses to one or two TNF inhibitors, respectively, versus 14.8% and 18.4% of placebo-treated patients.
And ixekizumab was significantly superior to placebo for the proportion of patients achieving a good DAS28-CRP response rate at week 24, at a respective 46.5% versus 10.3% among those with an inadequate response to one TNF inhibitor and 41.5% versus 4.9% among those with an inadequate response to two, as well as for patients achieving Disease Activity in Psoriatic Arthritis score of 14 or below (42.3 and 34.1% vs 16.2 and 4.9%), and minimal disease activity (31.0 and 19.5% vs 4.4 and 2.4%).
“In this difficult to treat population of patients we saw a significant improvement compared to placebo at week 24 in the outcomes that we studied,” Gellett commented, noting that for all outcomes, improvements seen with ixekizumab were “consistent through week 52” with continuous dosing of the drug.
By Lucy Piper
medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group
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