Paediatric psoriasis: ixekizumab beneficial in difficult-to-treat areas

High clearance rates in challenging body areas of children were observed on long-term ixekizumab treatment for psoriasis. After 108 weeks, scalp psoriasis, for example, was cleared in 76.2% and genital psoriasis in 87.5% of patients.

Psoriasis involving certain difficult-to-treat areas of the body can account for a more substantial impact on quality-of-life than might be expected from just looking at the surface area involved [1]. Thus, an international group with primary investigator Dr Marieke Seyger (Radboud University Medical Centre, the Netherlands) focussed on the long-term efficacy of ixekizumab in children and adolescents with moderate-to-severe psoriasis, especially in these areas [2]. They presented data from the phase 3 IXORA-PEDS trial (NCT03073200) and its open-label extension until week 108.

Of the 171 participants randomised in the placebo-controlled study phase, 83.7% concluded the extension phase after more than 2 years. The mean age at baseline was between 13 and 14 years, and the diagnosis of psoriasis had been established at a mean of 4.7 years before. The overall efficacy results showed Psoriasis Area and Severity Index (PASI)75, 90, and 100 responses of 91.7%, 79.0%, and 55.1%, respectively [1]. A considerable proportion of participants in the placebo and the ixekizumab arms presented with affections in challenging areas at baseline: nails (Nail Psoriasis Severity Index Score (NAPSI) >0: 21.4% and 29.6%, respectively), scalp (Psoriasis Scalp Severity Index score (PSSI) >0: 89.3% and 88.7%), and palmoplantar (Palmoplantar Psoriasis Area and Severity Index (PPASI) >0: 16.1% and 14.8%) [2]. The detailed analysis of these sites found clearance of psoriasis in a substantial percentage of participants at week 108: 68.1% achieved NAPSI=0, 76.2% PSSI=0, 90% PPASI 100, and 87.5% had no psoriasis on the genitals. Furthermore, a significant reduction in itch from baseline (P<0.001) was observed.

The investigators further emphasised that these challenging body areas significantly impact patients’ quality-of-life.

1. Paller AS, et al. JAMA Dermatol. 2022;158:533-541.
2. Seyger M, et al. Efficacy of ixekizumab in challenging body areas in pediatric patients with moderate-to-severe plaque psoriasis (IXORA-PEDS) is maintained up to 108 weeks. P030, SPIN 2022 Congress, 06–08 July, Paris, France.

 

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Posted on 26 August 2022