Efficacy and safety of ixekizumab in patients with plaque psoriasis across different degrees of disease severity: results from UNCOVER-2 and UNCOVER-3

Purpose: To evaluate short- and long-term efficacy and safety of ixekizumab in patients according to psoriasis severity. Materials and methods: Data were integrated from clinical trials (UNCOVER-2, UNCOVER-3). Patients received placebo, 80-mg ixekizumab every 2 weeks (IXEQ2W), every 4 weeks (IXEQ4W), or 50 mg etanercept (ETN) biweekly for 12 weeks, then open-label IXEQ4W (UNCOVER-3). Psoriasis severity was categorized by baseline Psoriasis Area and Severity Index (PASI <20 and >= 20). Efficacy was evaluated by percentage reaching PASI 75, 90, 100, and absolute PASI <= 5, <= 2, and <= 1. Results: Significantly more patients with PASI >= 20 (vs. PASI <20) were male and had higher body weight. After 12 weeks, both severity groups had significantly more IXEQ2W- than ETN-treated patients reach PASI 75, 90, 100, and absolute PASI <= 5, <= 2, <= 1. Fewer PASI >= 20 vs. PASI <20 patients across treatments reached PASI <= 5, <= 2, and <= 1 at week 12. Efficacy was maintained during 156 weeks of ixekizumab treatment with no differences between groups. The IXEQ2W safety profile was similar between groups except for injection-site reactions (significantly higher in PASI <20). Conclusions: Ixekizumab demonstrated a high level of efficacy and had a consistent safety profile in patients with different baseline psoriasis severity levels.