Objectives: Ixekizumab (IXE) is a high-affinity monoclonal antibody that selectively targets interleukin-17A and has demonstrated superiority to ustekinumab (UST) at 12 weeks. Bothersome symptoms through 24 weeks are presented. MethOds: In this trial (IXORA-S, NCT02561806), patients were randomized (1:1) to receive either IXE (160-mg starting dose, then 80-mg every 2 weeks for 12 weeks followed by 80-mg every 4 weeks; N= 136) or UST (45-mg/90-mg weight-based dosing per label; N= 166). At Week 12 and 24, categorical data were assessed using non-responder imputation (NRI). Itch and skin pain were measured using a 0-10 numeric rating scale (0= no itch, 10= worst itch imaginable) and 100mm visual analog scale (VAS) (0= no pain; 100 worst pain imaginable) in previous 24 hours, respectively. The proportions reaching 0 for itch and skin pain between treatment groups at each time point (except week 12 and week 24) were compared using Fisher's Exact test (NRI). Results: At baseline, 2.2% of IXE-treated and 2.4% of UST-treated patients reported no itching; and no skin pain for 8.8% of IXE and 12% of UST patients was reported. At weeks 4, 8 and 16, statistically, significantly greater proportions of IXEtreated patients vs. UST patients achieved complete reduction in itching. By week 24, the proportions of IXE vs. UST patients who indicated no itching were 46.3% vs. 33.7% (p= 0.051). For skin pain, at weeks 2, 4, 8 and 16, statistically significantly greater proportions of IXE patients reported no skin pain compared to UST patients; while by week 24 the proportions of patients indicating no pain were 48.5% (IXE) vs. 36.1% (UST) (p= 0.051). cOnclusiOns: Psoriasis symptoms of itching and skin pain were resolved early with IXE treatment compared to UST, while the proportions with complete resolution between treatments converged by week 24.
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