Ixekizumab

Ixekizumab is a humanized synthetically produced IgG4 monoclonal antibody with a molecular weight of 146 kDa. Ixekizumab has immunosuppressive and anti-inflammatory effects and is used for the treatment of moderate to severe plaque psoriasis.

Ixekinumab binds with high affinity to interleukin-17A (IL-17A) and inhibits interaction with the IL-17 receptor. IL-17A is a pro-inflammatory cytokine secreted by Th17 helper cells. IL-17a is involved in the inflammatory response 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, in which 363 patients worldwide participated, it was demonstrated that patients with confirmed psoriatic arthritis (CASPAR criteria) can still be treated effectively after unsuccessful therapy with TNF-alpha blockers.

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. Leonardi C et al (2012) Anti-interleukin-17 monoclonal antibody ixekizumab in chronic plaque psoriasis. N Engl J Med 366: 1190-11999
4. Nash P et al (2017) Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors: results from the 24-week randomised, double-blind, placebo-controlled period of the SPIRIT-P2 phase 3 trial. Lancet 389:2317-2327.
5. 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
6. 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