Background and importance Ixekizumab is a high affinity monoclonal antibody against interleukin 17A. It is used for the treatment of moderate-to-severe plaque psoriasis (MTSPP).

Aim and objectives To assess the effectiveness and safety of ixekizumab in MTSPP in clinical practice.

Material and methods A descriptive, retrospective, multicentre study was conducted. Patients with MTSPP receiving ixekizumab between 1 January 2017 and 30 September 2020 were included. Electronic clinical history and the prescription programme Farmatools were used to record data: sex, age, previous treatment, dosage and duration of therapy. Effectiveness was measured by the psoriasis area severity index (PASI): PASI-75 (≥75% reduction in baseline PASI), PASI-90 (≥90% reduction) and PASI-100 (total clearance of lesions) at weeks 12 and 36. Failure to achieve PASI-75 was considered no response. Safety was evaluated according to adverse events (AE) and discontinuations of treatment.

Results 46 patients were included, 27 (59%) were men. Mean age was 49 (23–74) years. Previous treatments: methotrexate (n=33), cyclosporine (n=29) and biological therapy (n=35). Mean number of prior biological drugs was 3 (1–5), including anti-TNF (etanercept, n=23; adalimumab, n=22; infliximab, n=3), anti-IL-12-23 (ustekinumab, n=16) and anti-IL-17A (secukinumab, n=7). All patients received ixekizumab with an induction dose of 160 mg at week 0 and then 80 mg at weeks 2, 4, 6, 8, 10 and 12. Maintenance dose was 80 mg every 4 weeks in 34 (74%) patients and every 6 weeks in 12 (26%). Mean duration of ixekizumab therapy was 17 (3–44) months.

Baseline PASI was >5 in all patients and >10 in 37 (80%) cases. Effectiveness was not evaluated in 5 (11%) patients at week 12 and in 8 (17%) patients at week 36 due to lack of information. At week 12: 1 (2%) patient presented PASI-75, 12 (26%) PASI-90, 23 (50%) PASI-100 and 5 (11%) no response. At week 36: 1 (2%) patient achieved PASI-75, 15 (33%) PASI-90, 16 (35%) PASI-100 and 6 (13%) no response. Regarding the safety profile, 3 (7%) patients presented AE: alopecia, eosinophilia and injection site reaction. No discontinuations of treatment were reported.

Conclusion and relevance Ixekizumab was effective and provided total clearance of MTSPP lesions to half of the patients by week 12, with this considerable response in more than a third of patients at week 36. Ixekizumab was well tolerated, with a low frequency of AE.

Conflict of interest No conflict of interest