Ixekizumab treatment in patients with active skin psoriasis: effectiveness compared to placebo
Näytönastekatsaukset
15.6.2020
Level of evidence: A
Ixekizumab treatment at the dose of 80 mg, when compared to placebo, increases the proportion of patients with active skin psoriasis to achieve a clinically meaningful improvement at 12 weeks of treatment.
There seems to be no clinically relevant differences in efficacy between 2-weeks and 4-weeks interval dosing regimens. However, treatment seems to have more adverse events than placebo at 12 weeks of treatment.
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias «Ixekizumab treatment in patients with active skin psoriasis: effectiveness compared to placebo»1 |
|---|---|---|---|---|---|
| «Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, bro»1 | SR/MA | Adult (at least 18 years) patients with moderate to severe plaque psoriasis.RCTs reporting outcomes at 12-16 weeks. | Ixekizumab 80mg every 4 weeks (4WR); Ixekizumab 80mg every 2 weeks (2WR); placebo | Primary: PASI-75 orPGA/IGA 0/1 by 12-16 weeks;Secondary: PASI-90 by 12-16 weeks,Adverse events, including withdrawals due to toxicity | Low |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| I= intervention; C=comparison; CI=confidence interval 4WR = Ixekizumab 80mg every 4 weeks 2WR = Ixekizumab 80mg every 2 weeks | |||||
| «Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, bro»1 | 3 RCTs with 3126 participants (2334/792) | 12 weeks | 4WR: 951 (81.6) 2WR: 1037 (88.7) | PLAC: 35 (4.4) | 4WR: RR 18.2 (10.6-31.2); 2WR: RR 19.8 (11.1-35.5) |
| Level of evidence: high | |||||
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| 4WR = Ixekizumab 80mg every 4 weeks 2WR = Ixekizumab 80mg every 2 weeks | |||||
| «Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, bro»1 | 3 RCTs with 3126 participants (2334/792) | 12 weeks | 4WR: NA 2WR: NA | PLAC: NA | 4WR: RR 53.6 (14.0-204.7); 2WR: RR 63.8 (15.2-267.5) |
| Level of evidence: moderate Assess the risk of bias and delete irrelevant sources of bias: The quality of evidence is downgraded due to, imprecision. | |||||
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| I= intervention; C=comparison; CI=confidence interval 4WR = Ixekizumab 80mg every 4 weeks 2WR = Ixekizumab 80mg every 2 weeks | |||||
| «Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, bro»1 | 3 RCTs with 3126 participants (2334/792) | 12 weeks | 4WR: 874 (79.4) 2WR: 956 (81.8) | 31 (3.9) | 4WR: RR 18.8 (10.4-34.2); 2WR: RR 20.4 (11.0-37.8) |
| Level of evidence: high | |||||
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| 4WR = Ixekizumab 80mg every 4 weeks 2WR = Ixekizumab 80mg every 2 weeks | |||||
| «Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, bro»1 | 3 RCTs with 3126 participants (2334/792) | 12 weeks | 4WR: 33 (2.8) 2WR: 33 (2.8) | 11 (1.4) | RR 2.4 (1.2-4.6) (4WR) and 2.4 (1.2-4.7) (2WR). |
| Level of evidence: low Assess the risk of bias and delete irrelevant sources of bias: The quality of evidence is downgraded due to study limitations, imprecision. | |||||
References
- Bilal J, Berlinberg A, Bhattacharjee S ym. A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab and tildrakizumab for the treatment of moderate to severe plaque psoriasis. J Dermatolog Treat 2018;29:569-578 «PMID: 29532693»PubMed