Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis

N Engl J Med 2016;375:345–56. doi: 10.1056/NEJMoa1512711

Gordon, et al. pool the results of UNCOVER-1, UNCOVER-2, and UNCOVER-3 to show that ixekizumab increases the proportion of patients achieving an sPGA score of 0/1 or PASI 75 versus placebo. Adverse events related to ixekizumab treatment included neutropenia, candidal infections, and inflammatory bowel disease.

Phase 3 studies comparing brodalumab with ustekinumab in psoriasis

N Engl J Med 2015;373:1318–28. doi: 10.1056/NEJMoa1503824

Brodalumab treatment resulted in a rapid reduction in the signs and symptoms of PsO. The median time to a PASI 75 response with 210 mg of brodalumab Q2W was 4 weeks, approximately twice as fast as the median time to a response with ustekinumab.

Researchers reported the safety and efficacy of deucravacitinib over 2 years in patients with chronic plaque PsO. The most frequently reported AEs were nasopharyngitis, URTI, and COVID-19.

Week 16 primary outcomes of improved PASI 90 response and sPGA score demonstrated Mirikizumab superiority to placebo and non-inferiority to secukinumab. This study presented results from the OASIS-2 trial on the safety and efficacy of mirikizumab compared with secukinumab and placebo in patients with moderate-to-severe plaque psoriasis.

Week 16 coprimary endpoints of PASI 75 response and sPGA score improved in the majority of patients and was overall maintained through week 52. Deucravacitinib therapy was also associated with a low AE rate. This study presented results from the POETYK PSO-4 trial on the safety and efficacy of deucravacitinib 6mg QD in Japanese patients with psoriasis.

This pooled analysis of the Phase 3 PSO-1 and PSO-2 trials shows that deucravacitinib has greater efficacy in treating scalp PsO than placebo and apremilast. At week 16, response rates were greater with deucravacitinib versus placebo or apremilast for scalp-specific Physician Global Assessment 0/1 and Psoriasis Scalp Severity Index. Efficacy was maintained through 52 weeks in patients who received continuous deucravacitinib treatment.

Here, investigators reported that efficacy measures for skin and scalp were significantly greater for apremilast than for placebo in patients with PsO at baseline. Previously, clinical study data has highlighted that the use of apremilast leads to a reduction in the expression within the epidermis of numerous inflammatory cytokines relevant to PsO. As a result, ESTEEM 1 evaluated the efficacy/safety of apremilast at 30 mg BID for moderate to severe PsO.

Bimekizumab versus adalimumab in plaque psoriasis

N Engl J Med 2021; 385:130–41. doi: 10.1056/NEJMoa2102388

Bimekizumab was noninferior and superior to adalimumab with respect to PASI 90 response and IGA score at Week 16. Bimekizumab is a promising IL-17A/F inhibitor that has shown clinical improvement in PsO patients compared to placebo and other IL inhibitors. Warren et al. compared the safety and efficacy of bimekizumab with adalimumab in a 56-week double-blind trial.

This Phase 3 study by Strober, et al. reports deucravacitinib superiority to placebo and apremilast in patients with PsO. The authors found that deucravacitinib had significantly higher rates of PASI 75 and sPGA achievement than placebo and deucravacitinib.

Deucravacitinib has shown efficacy in the treatment of both skin and joint disease. As a result, researchers sought to compare the efficacy and safety of deucravacitinib versus placebo and apremilast in adults with moderate to severe plaque PsO.