Early Response is Associated With Stable Long-Term Response in Psoriasis Patients Receiving Ixekizumab or Ustekinumab

BACKGROUND: The identification of early treatment factors that predict the long-term success of maintenance therapy for psoriasis may help optimize individual therapy.

OBJECTIVE: To determine early treatment response rates to ixekizumab and ustekinumab and assess whether early response was associated with stable long-term response to these treatments in patients with moderate-to-severe psoriasis.

METHODS: This post hoc subgroup analysis of the IXORA-S study (NCT02561806) measured disease severity using the Psoriasis Area Severity Index (PASI) and determined the percentage of patients treated with ixekizumab or ustekinumab who showed PASI 50 at week 2 or 4 (early response) and assessed whether early response was associated with maintaining complete (PASI 100) or almost complete (PASI 90) skin clearance at 80% of monthly visits during weeks 16−52 of treatment (stable response). Nonresponder imputation was used for missing PASI response status.

RESULTS: A numerically higher portion of patients treated with ixekizumab were early responders and were significantly more likely to achieve a stable PASI 90 response (P<.0001) or PASI 100 response (P<.0001) than patients treated with ustekinumab. Patients treated with ixekizumab or ustekinumab who were early responders were more likely to achieve a stable response of PASI 90 or 100 (odds ratio>1).

CONCLUSION: In patients with moderate-to-severe psoriasis treated with ixekizumab or ustekinumab, early response was a significant factor in maintaining stable complete or almost complete skin clearance. Therefore, rapid response is a clinically relevant factor to consider when optimizing individual therapeutic strategies. J Drugs Dermatol. 2022;21(2):122-126. doi:10.36849/JDD.6063.