Eli Lilly’s Taltz (ixekizumab) for plaque psoriasis produces positive results
Eli Lilly has announced that the New England Journal of Medicine has published detailed results from three pivotal phase III studies—UNCOVER-1, UNCOVER-2 and UNCOVER-3—that demonstrated the efficacy and safety of Taltz (ixekizumab) through 60 weeks in patients with moderate-to-severe plaque psoriasis. This publication also detailed 12-week efficacy data for patients treated with Taltz in UNCOVER-1.
In all three studies, responders to Taltz through 12 weeks demonstrated high levels of skin clearance through 60 weeks.
“This group of studies show that patients on Taltz are able to achieve high levels of efficacy, and that the majority of patients are able to maintain or continue to improve their response with continued treatment through 60 weeks,” said Kenneth Gordon, M.D., a professor of dermatology at Northwestern University Feinberg School of Medicine and first author of the paper.
All three studies evaluated the safety and efficacy of Taltz (80mg every two weeks, following a 160mg starting dose) compared to placebo after 12 weeks. UNCOVER-2 and UNCOVER-3 included an additional comparator arm in which patients received etanercept (50mg twice a week) for 12 weeks. All three studies also evaluated response rates with Taltz every four weeks through 60 weeks. In UNCOVER-1 and UNCOVER-2, patients treated with Taltz who achieved clinical response (static Physician’s Global Assessment score [sPGA] 0 or 1) at 12 weeks were re-randomized to receive Taltz (80mg every four weeks) or placebo through 60 weeks. In UNCOVER-3, all patients completing 12 weeks continued the study receiving Taltz (80mg every four weeks) through 60 weeks.
In all three studies, the co-primary efficacy endpoints at 12 weeks were Psoriasis Area Severity Index score (PASI) 75 and sPGA 0 or 1. PASI measures the extent and severity of psoriasis by assessing average redness, thickness and scaliness of skin lesions (each graded on a zero to four scale), weighted by the body surface area of involved skin, while the sPGA is the physician’s assessment of severity of a patient’s psoriasis lesions overall at a specific point in time and is a recommended measure the FDA uses to evaluate effectiveness. In all three studies, sPGA and PASI were also assessed through 60 weeks.
In UNCOVER-1, Taltz given every two weeks was statistically superior to placebo, with high levels of clearance achieved at 12 weeks among patients treated with Taltz, the majority of whom achieved virtually clear (PASI 90) or completely clear skin (PASI 100, sPGA 0).
- 8% of patients treated with Taltz achieved sPGA 0 or 1 compared to 3.2% of those treated with placebo (p<0.001).
- 1% of patients treated with Taltz achieved PASI 75 compared to 3.9% of patients treated with placebo (p<0.001).
- 9% of patients treated with Taltz achieved PASI 90 compared to 0.5% treated with placebo (p<0.001).
- 3% of patients treated with Taltz achieved complete resolution of psoriasis plaques (PASI 100) compared to zero patients treated with placebo (p<0.001).
In UNCOVER-1 and UNCOVER-2, high levels of clearance also were achieved through 60 weeks among patients treated with Taltz every two weeks who achieved clinically meaningful response (sPGA 0 or 1) at 12 weeks, the majority of whom achieved virtually clear or completely clear skin through 60 weeks when treated with Taltz every four weeks.
In UNCOVER-1 and UNCOVER-2 through 60 weeks:
- 3% of patients maintained sPGA 0 or 1.
- 3% of patients achieved PASI 75.
- 5% of patients achieved PASI 90.
- More than half of patients (57.5%) achieved complete resolution of skin plaques (PASI 100).
In UNCOVER-3, high levels of clearance were also achieved with Taltz given every four weeks through 60 weeks among patients initially treated with Taltz every two weeks:
- 5% of patients achieved sPGA 0 or 1.
- 4% of patients achieved PASI 75.
- 2% of patients achieved PASI 90.
- More than half of patients (55.3%) achieved complete resolution of skin plaques (PASI 100).
“Over the last several years, advances in our understanding of psoriasis have led to the development of new treatment targets that may provide higher levels of skin clearance,” said Aarti Shah, Lilly’s global brand development leader for Taltz. “The results of these analyses are significant, demonstrating that the majority of patients treated with Taltz through 60 weeks achieved or maintained virtually or completely clear skin.”
Information regarding the safety of Taltz is drawn from a database of 4,204 patients with moderate-to-severe plaque psoriasis who volunteered in both controlled and uncontrolled clinical trials.
Taltz may increase the risk of infection. Patients treated with Taltz had a higher rate of infections than patients treated with placebo (27% vs. 23%). Upper respiratory tract infections, oral candidiasis, conjunctivitis and tinea infections occurred more frequently in patients treated with Taltz compared to placebo. Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
Other warnings and precautions for Taltz include pre-treatment evaluation for tuberculosis, hypersensitivity reactions, inflammatory bowel disease and immunizations.