Ixekizumab 80mg/1ml solution for injection pre-filled syringes

BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory disease that impacts both the skin and joints. Currently, interleukin (IL)-17, IL-12/23, and IL-23 inhibitors have become integral components of PsA treatment regimens. Nevertheless, the comparative effectiveness of these IL-targeted therapies remains a subject of ongoing debate. This study employs a network meta-analysis (NMA) approach to systematically evaluate the therapeutic efficacy and safety profiles of various IL-17, IL-12/23, and IL-23 inhibitors.MethodsWe searched PubMed, Web of Science, and Embase for randomized controlled trials (RCTs) to identify eligible research articles. This NMA was implemented by Stata 14.0 software, with odds ratios (ORs) and 95% confidence intervals (CIs) serving as effect and safety measures to evaluate clinical efficacy and safety profiles. Drugs were ranked based on their efficacy and safety profiles using the surface under the cumulative ranking curve values, enabling a comprehensive comparative assessment of interventional strategies. The CINeMA (Confidence in Network Meta-Analysis) online tool was utilized to evaluate the confidence level of the NMA results.ResultsThis NMA included 22 RCTs and 9,241 patients. All intervention groups demonstrated superior efficacy to the placebo group. Based on efficacy endpoints and subgroup analyses, bimekizumab, secukinumab, and ixekizumab exhibited superior short-term efficacy. Notably, subgroup analyses suggested that tildrakizumab may represent a promising therapeutic option for PsA. Regarding safety and the risk of adverse events, all treatments demonstrated no significant differences compared to placebo, except bimekizumab 160 mg every 4 weeks (Q4W) (OR = 1.37, 95% CI: 1.08-1.74). There were no significant differences in terms of serious adverse events and upper respiratory tract infection. Bimekizumab 160 mg Q4W showed heightened risk of nasopharyngitis (OR = 2.30, 95% CI: 1.26-4.22).ConclusionsThis NMA showed that IL-17, IL-12/23, and IL-23 inhibitors demonstrated remarkable efficacy in attaining ACR20, ACR50, ACR70, and MDA after 12, 16, or 24 weeks of treatment. Among these, IL-17 inhibitors-particularly bimekizumab, secukinumab, and ixekizumab-exhibited notably pronounced therapeutic effects. However, bimekizumab showed a less favorable clinical safety profile compared to other biological agents. In contrast, secukinumab and ixekizumab demonstrated a favorable balance of relatively high efficacy and low risk when considering safety profiles.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251023787, identifier CRD420251023787.

Abstract licence: CC BY

BackgroundInterleukin inhibitors represent a standard therapeutic approach for psoriasis. However, there is still debate about the risk of new-onset inflammatory bowel disease (IBD) in psoriasis patients following interleukin inhibitor treatment. This systematic review and meta-analysis aims to evaluate the risk of new-onset IBD in psoriasis patients treated with five interleukin inhibitors (Bimekizumab, Ixekizumab, Secukinumab, Brodalumab, and Ustekinumab), providing insights to inform clinical decision-making.MethodThis study was registered in the PROSPERO with registration number of CRD42024608423. The databases PubMed, Embase, Cochrane Library, and Web of Science were comprehensively searched for observational studies published as full-length papers in English. The Mantel-Haenszel method with a fixed-effects model and risk difference was used to compare the risk of new-onset IBD between experimental groups (using interleukin inhibitors) and the control groups (using placebo or non-interleukin inhibitors). Sensitivity analysis was performed using the leave-one-out method for the meta-analysis. Additionally, considering the potential for underdiagnosis of IBD, a meta-analysis of the risk of diarrhea was conducted.ResultThis study included 17 articles covering 21 Randomized Controlled Trials(RCTs). A total of 22 new-onset IBD cases were reported in the experimental groups, with 3, 14, 4, 1, and 0 cases in the Bimekizumab, Ixekizumab, Secukinumab, Brodalumab, and Ustekinumab group, respectively. The control group only reported 1 case of new-onset IBD. No significant difference in the risk of new-onset IBD was found between these experimental groups and control groups. Based on the fixed-effects model, the pooled risk difference for Ixekizumab group was MH RD 0.0027 (95% CI 0.0001-0.0054, I² = 0%, P = 0.04). Sensitivity analysis indicated that the data was stable. Regarding diarrhea, a total of 95 cases were reported in the experimental groups, compared to 50 cases in the control groups. The experimental groups of Bimekizumab, Secukinumab, and Brodalumab reported 49, 45, and 1 case of diarrhea, respectively, while their control groups reported 11, 39, and 0 cases, respectively. Based on the fixed-effects model, compared to the control groups, there were no significant differences in the risk of diarrhea among psoriasis patients treated with these three interleukin inhibitors, and sensitivity analysis demonstrated good data robustness. Additionally, no cases of diarrhea were reported in the Ixekizumab group and Ustekinumab group.ConclusionsThere is insufficient evidence to confirm that Ustekinumab, Bimekizumab, Secukinumab, and Brodalumab significantly increase the risk of new-onset IBD. However, compared to the control group, Ixekizumab was significantly associated with an increased risk of new-onset IBD in psoriasis patients. Psoriasis patients receiving Ixekizumab treatment should remain vigilant for gastrointestinal symptoms, particularly in high-risk patients, to identify and manage potential IBD early. Additionally, compared to the control group, no significant difference was observed in the risk of diarrhea as an adverse event among patients treated with Bimekizumab, Secukinumab, and Brodalumab.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024608423, identifier CRD42024608423.

Abstract licence: CC BY

IntroductionRecent trials with withdrawal arms in patients with psoriasis have highlighted the need for updated clinical guidance. The aim of this investigation was to compare the effects and safety of planned limited-time withdrawal versus continuous maintenance of interleukin (IL) inhibitors in patients with psoriasis.MethodsOn August 5, 2025, the following platforms were systematically searched: PubMed, Embase, Clarivate (Web of Science), Scopus, and Ovid. Titles and abstracts, followed by full-text articles, were independently screened by two reviewers, with any disagreements being resolved by a third reviewer. Certainty of evidence was evaluated via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Network meta-analyses for the Psoriasis Area and Severity Index (PASI) 90 and PASI100 outcomes were performed. The risk ratio (RR) of relapse was ranked using the surface under the cumulative ranking curve (SUCRA) metric.ResultsA total of 7444 records were retrieved, 54 of which included data from 18 different trials. The data revealed a total of 2995 patients who were subjected to anti-IL withdrawal regimens that were eligible for comparison with anti-IL maintenance. For the PASI90 outcome, the network meta-regression, adjusted for a post-withdrawal follow-up duration of 40-48 weeks, indicated that bimekizumab demonstrated a RR for relapse (RR 5.36; 95% confidence interval (CI) 3.45-8.34; SUCRA 0.685) comparable to that of guselkumab (RR 7.45; 95% CI 4.97-11.19; SUCRA 0.412) and lower than that of ixekizumab (RR 17.45; 95% CI 10.22-29.80; SUCRA 0.006). No significant difference in adverse event rates was observed between the anti-IL withdrawal and maintenance groups.ConclusionsCompared with continued treatment, planned withdrawal of anti-IL therapy is associated with a largely superior risk of relapse, without any reduction in the incidence of adverse events. Moreover, bimekizumab withdrawal demonstrated better outcomes than ixekizumab withdrawal did according to the PASI90 outcome.Study registrationThis study was prospectively registered on PROSPERO (identification number CRD420251118724).

Abstract licence: CC BY-NC