Clinical experience of ixekizumab in the treatment of patients with history of chronic erythrodermic psoriasis who failed secukinumab: a case series

Abstract

3 Lacruz RS, Feske S. Diseases caused by mutations in ORAI1 and STIM1. Ann N Y Acad Sci 2015; 1356:45-79. 4 Lian J, Cuk M, Kahlfuss S et al. ORAI1 mutations abolishing store-operated Ca 2+ entry cause anhidrotic ectodermal dysplasia with immunodeficiency. J Allergy Clin Immunol 2018; 142:1297-310. 5 Davis FM, Janoshazi A, Janardhan KS et al. Essential role of Orai1 store-operated calcium channels in lactation. Proc Natl Acad Sci USA 2015; 112:5827-32. 6 Endo Y, Noguchi S, Hara Y et al. Dominant mutations in ORAI1 cause tubular aggregate myopathy with hypocalcemia via constitutive activation of store-operated Ca 2+ channels. Hum Mol Genet 2015; 24:637-48. 7 Vandenberghe M, Raphael M, Lehen'kyi V et al. ORAI1 calcium channel orchestrates skin homeostasis. Proc Natl Acad Sci USA 2013; 110: E4839-48. 8 Numaga-Tomita T, Putney JW. Role of STIM1-and Orai1-mediated Ca 2+ entry in Ca 2+ -induced epidermal keratinocyte differentiation.

Successful combined treatment of Buschke–Lowenstein tumor in anal canal with electroresection, photodynamic therapy and topical 5% imiquimod

“…3 However, complications such as anal reconstruction or stenosis are quite common postoperatively. There is limited literature on anal condyloma acuminatum cases being treated with photodynamic therapy 4 Recurrences in our case was probably caused by incomplete resection of the condyloma lesion inside the anal canal. Laser-mediated photodynamic therapy with 5-aminolevulinic acid is an emerging approach for treating genital HPV infection.…”

“…Failure of therapy with secukinumab has been reported and many such patients have been shifted to ixekizumab with good response, like in our case. 4 Ixekizumab, like secukinumab, targets IL-17A with a difference that it is humanized rather than being fully human. This difference may account for its higher immunogenicity.…”

“…Besides, ixekizumab shows higher affinity and stability to IL-17A than secukinumab. 4 It has also been proposed that the two antagonists may be targeting different epitopes of IL-17, thus leading to variation in response. 5 This might explain the response to ixekizumab in our patient who failed secondarily on secukinumab and for the faster onset of action with the former.…”

Updates on the Treatment of Erythrodermic Psoriasis

“…106 For patients with prior failure with secukinumab, ixekizumab still demonstrated a rapid response as early as week 4. 107 Suboptimal responses were reported in only four (44%) patients, who achieved PASI 75 at week 12 according to a previous study. In addition, the response was even poorer after prolonged use.…”

Ixekizumab as treatment of erythrodermic psoriasis

“…An open label study (UNCOVER‐J) in Japanese subjects highlighted the efficacy and safety of ixekizumab in patients with EP, with a maintained response over 52 weeks 9,10 . Ixekizumab also been shown in real‐life report to induce long‐term remission in EP, even over 3 years, proving safety even in HIV‐infected patients 12‐15 . Furthermore, considering the higher rate of relapse in patients treated with secukinumab, it could be possible to prefer ixekizumab in these patients 8 …”