Ixekizumab (Taltz^®)

In case you’re on the fence about taking Taltz, here is some case study statistics for you to read. Taltz has no black box warnings. They also approved the drug for children over six years of age. I was on Taltz and I found it extremely effective. At the time it was painful to inject. They now make it without the citrate as a preservative, so the medication is painless to take. Overall I rate this drug a 9 out of 10 only because I got 4 years of use rather than 5. The content below is cited by NCBI.

“Ixekizumab is a high-affinity, humanized IgG4 monoclonal antibody for IL-17A, inhibiting interaction with the IL-17 receptor. FDA indications for ixekizumab include plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. The loading dose is 160 mg SC at week 0 and subsequent doses of 80 mg at weeks 2, 4, 6, 8, 10, and 12. Maintenance dosing is continued at 80 mg SC every 4 weeks. To maintain response to treatment, practitioners can consider increasing the dosing regimen to 80 mg SC every 2 weeks. It is the only biologic with data and FDA labeling specifically for genital plaque psoriasis. Also, ixekizumab is the only IL-17 agent that is FDA approved for treatment of plaque psoriasis down to the age of 6 years old. Ixekizumab was shown to be superior to placebo in the treatment of moderate‐to‐severe pediatric psoriasis, and the safety profile was generally consistent with that observed in adults.

Ixekizumab has very high efficacy as demonstrated through a PASI 75 achievement in 90% of patients by week 12. Efficacy data points to ixekizumab as being the fastest acting biologic. Head-to-head comparison showed a faster onset of action than guselkumab in the treatment of plaque psoriasis In head-to-head studies against adalimumab for treatment of psoriatic arthritis, both biologics were found to have similar symptom control and inhibition of joint destruction and bone erosion. Additionally, when both PASI 100 rates and psoriatic arthritis improvement results were combined, ixekizumab was superior to adalimumab.

Head-to-head comparison showed faster onset of action for ixekizumab vs guselkumab in the treatment of plaque psoriasis. The red box indicates the primary endpoint for the study. Notes:Reproduced from Blauvelt et. al. Ixekizumab vs. Guselkuamb: …

Ixekizumab is a well-tolerated biologic with minimal adverse events. It has no black box safety warnings and no evidence of increased tuberculosis risk. Of note, there is a higher rate of injection site pain and reaction, but during phase III studies 97% of patients with a reaction did not find it significant enough to discontinue the study. Injection site reaction was actually noted to improve over the course of treatment. There is also a concern of increased risk of IBD, however, the incidence of new-onset IBD is less than 1 out of 1000 patients on ixekizumab. Studies showed a slight increase in superficial fungal and yeast infections, although the candida rate in phase III studies is still less than 0.6% while on the once every 4 weeks dosing regimen versus 0.5% on placebo.”

Getting Cozy with Cosentyx. Here is the information about the drug according to NCBI.

Secukinumab (Cosentyx®)

Secukinumab is a fully human G1k monoclonal antibody, which selectively binds and inhibits IL-17A. It is currently FDA approved for plaque psoriasis, ankylosing spondylitis, psoriatic arthritis, and active non-radiographic axial spondyloarthritis. Dosing of secukinumab for the treatment of psoriasis starts with a loading dose of 300 mg given SC at weeks 0, 1, 2, 3, and 4, followed by a maintenance dose of 300 mg SC every 4 weeks. In patients with lower body weight and minimal disease severity, 150 mg may be acceptable for maintenance dosing. For patients who may need higher doses, such as those with resistant disease and/or higher BMI, published data show a possible benefit of increasing dosing of secukinumab to 300mg SC every 2 weeks during maintenance. Higher dosing resulted in numerically superior efficacy, but due to size of the study, the difference was not statistically significant.

Secukinumab has excellent efficacy in the treatment of several disease domains. Dedicated studies for difficult to treat areas such as scalp, nail and palmoplantar psoriasis have been completed with data showing sustained efficacy for greater than 2 years for the latter two conditions. Secukinumab possesses higher efficacy versus several other subcutaneous biologic agents, showing superiority in head-to-head trials against both etanercept and ustekinumab. It also is the only biologic with a study showing efficacy for the treatment of axial psoriatic arthritis. Additionally, it has been recognized by the FDA for its efficacy in inhibiting psoriatic joint destruction, making it a better choice vs. an IL-23 or IL 12/23 agent for the treatment of psoriatic arthritis.
Clear skin responses (PASI 100) was greater among secukinumab treated patients compared to ustekinumab at every time point from week 4 out to week 16 in the CLARITY study.
Along with its exceptional clinical efficacy, it also has an extremely high recapture rate. After abrupt discontinuation of the drug and subsequent flare, restarting secukinumab led to 95% of patients achieving PASI 75 by week 12.

Secukinumab has the longest track record for safety in real-world usage out of all the IL-17 inhibitors and no black box safety warnings. It is one of the best tolerated biologic injectables in terms of injection site reactions and pain. While there is an already established association of increased re-activation and onset of tuberculosis risk in some biologics, particularly with TNF-alpha inhibitors, no study to date has found evidence of an increased tuberculosis risk in secukinumab.

There are very few adverse reactions of concern associated with secukinumab. Patients using secukinumab were found to have a mild increase in superficial fungal and yeast infections. Fungal rates in a phase III study for secukinumab, while increased over placebo, were less than 1%. Mucocutaneous candidiasis in the secukinumab treatment group was 1.2% vs. 0.3% placebo. Additionally, studies show an increased risk of inflammatory bowel disease (IBD); however, the incidence of new-onset IBD is less than 1 out of 1000 patients on secukinumab.

Overcoming Psoriasis has several drug specific groups and pages. For a more intimate experience about this medication I suggest you join our group(s) on Facebook. The medication support group for this specific medication is called Cosentyx support group. Thank you in advance for being a member. We strive to get you the most accurate and latest information possible.

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