Ixekizumab

Ixekizumab is a humanized, synthetically produced, monoclonal IgG4 antibody(IL-17A inhibitor) with a molecular weight of 146 kDa. Ixekizumab has an immunosuppressive and anti-inflammatory effect and is used for the treatment of moderate to severe plaque psoriasis.

Ixekinumab binds with high affinity to interleukin-17A (IL-17A) and inhibits the interaction with the IL-17 receptor. IL-17A is a pro-inflammatory cytokine that is secreted by Th17 helper cells. IL-17a is involved in the inflammatory reaction in psoriasis. Binding of the antibody leads to inhibition of keratinocyte activation and proliferation. The half-life of ixekinumab is 13 days.

In the SPIRIt-P2 study, which involved 363 patients worldwide, it was shown that patients with confirmed psoriatic arthritis (CASPAR criteria) can still be treated effectively even after unsuccessful therapy with TNF-alpha blockers.

IL-17A inhibition with ixeizumab is a well-tolerated mode of action across various indications. Ixeizumab is a well-tolerated mode of action across various indications. No new safety signals emerge even in long-term applications >5 years (Key Opinions in Medicine 15).

The recommended dose is initially 160 mg by s.c.(2x 80 mg injections), followed by 80 mg (1 injection) in weeks 2, 4, 6, 8, 10 and 12; the subsequent maintenance dose is 80 mg (1 injection) every 4 weeks.

The drug is administered as a subcutaneous injection. The most common potential adverse effects include upper respiratory tract infections and reactions at the injection site.

Taltz®.

Ixekizumab was approved in the USA, the EU and Switzerland in 2016 as an injection solution in a pre-filled pen and a pre-filled syringe. In Germany, the preparation has been available since March 2017. The antibody against IL-17A is indicated and well effective in moderate to severe plaque psoriasis (Blauvelt A et al. 2018)

1. Blauvelt A et al. (2018) Improvements in psoriasis within different body regions vary over time following treatment with ixekizumab. J Dermatolog Treat 29:220-229.
2. Farahnik B et al. (2016) Ixekizumab for the Treatment of Psoriasis: A Review of Phase III Trials. Dermatol Ther 6: 25-37
3. Key Opinions in Medicine 15 (2020)
4. Leonardi C et al. (2012) Anti-interleukin-17 monoclonal antibody ixekizumab in chronic plaque psoriasis. N Engl J Med 366: 1190-11999
5. Nash P et al. (2017) Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumor necrosis factor inhibitors: results from the 24-week randomized, double-blind, placebo-controlled period of the SPIRIT-P2 phase 3 trial. Lancet 389:2317-2327.
6. Ren V et al. (2013) Potential role of ixekizumab in the treatment of moderate-to-severe plaque psoriasis. Clin Cosmet Investig Dermatol 6: 75-80
7. Wang CQ et al (2014) IL-17 induces inflammation-associated gene products in blood monocytes, and treatment with ixekizumab reduces their expression in psoriasis patient blood. J Invest Dermatol 134: 2990-2993