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Ixekizumab: Comparison With Tildrakizumab in Psoriasis
No head-to-head data comparing ixekizumab with tildrakizumab are available. Indirect comparison analyses are provided below.
The information contained in this letter may not completely match the current local labeling for IXEKIZUMAB. Please see local labeling approved in your country.
Ixekizumab is a humanized IgG4 mAb that selectively binds with the IL-17A cytokine and inhibits its interaction with the IL-17 receptor. IL-17A is a naturally occurring cytokine involved in normal inflammatory and immune responses. Ixekizumab inhibits the release of proinflammatory cytokines and chemokines.1
No head-to-head trials have been conducted comparing the efficacy and safety of ixekizumab to that of tildrakizumab in the treatment of psoriasis.
Since clinical trials are conducted under widely varying and controlled conditions, efficacy outcomes and adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Tildrakizumab-asmn is a humanized IgG1/k mAb that selectively binds to the p19 subunit of IL-23 and inhibits its interaction with the IL-23 receptor. IL-23 is a naturally occurring cytokine that is involved in inflammatory and immune responses. Tildrakizumab inhibits the release of proinflammatory cytokines and chemokines.2
Adjusted Indirect Comparison of Ixekizumab and Tildrakizumab in Plaque Psoriasis
The methodology used to indirectly compare the efficacy outcomes (PASI 75, PASI 90, and PASI 100) of ixekizumab and tildrakizumab in patients with moderate-to-severe psoriasis were
- AIC using the Bucher method, and
- MAIC using the Signorovitch method in which reweighting was performed matching the following baseline characteristics in terms of means or percentages: patient age, sex, previous biologic treatment, PASI score, and BSA affected.3
Both methods of indirect comparisons used are subject to limitations including the potential for bias due to differences between trial populations and imbalances in unobserved factors between trials. These limitations can only be avoided with head-to-head randomized trials.4,5
As shown in , etanercept and placebo were used as the common comparators for the indirect comparison of ixekizumab and tildrakizumab.3
The authors concluded the results of this indirect comparison suggest that ixekizumab might provide clinical benefits over tildrakizumab in terms of faster onset of action and higher levels of skin clearance up to week 12 in patients with moderate-to-severe psoriasis.3
1Taltz [package insert]. Indianapolis, IN: Eli Lilly and Company; 2021.
2ILUMYA [package insert]. Sharjah, U.A.E.: Sun Pharma Global FZE, Inc; 2018.
3Gottlieb A, Saure D, Wilhelm S, et al. Indirect comparison of ixekizumab versus tildrakizumab for up to 12 weeks of treatment in patients with moderate-to-severe psoriasis. Poster presented at: 77th Annual Meeting of the American Academy of Dermatology; March 1-5, 2019; Washington, D.C. https://www.aad.org/eposters/Submissions/getFile.aspx?id=8051&type=sub
4Bucher HC, Guyatt GH, Griffith LE, et al. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol 1997;50(6):683-691. https://doi.org/10.1016/S0895-4356(97)00049-8
5Signorovitch JE, Wu EQ, Yu AP, et al. Comparative effectiveness without head-to-head trials: a method for matching-adjusted indirect comparisons applied to psoriasis treatment with adalimumab or etanercept. Pharmacoeconomics. 2010;28(10):935-945. http://dx.doi.org/10.2165/11538370-000000000-00000
AIC = adjusted indirect comparison
BSA = body surface area
IgG1 = immunoglobulin G subclass 1
IgG4 = immunoglobulin G subclass 4
IL = interleukin
mAb(s) = monoclonal antibody
MAIC = matched-adjusted indirect comparison
PASI = Psoriasis Area and Severity Index
PASI 75 = 75% improvement from baseline in Psoriasis Area and Severity Index
PASI 90 = 90% improvement from baseline in Psoriasis Area and Severity Index
PASI 100 = 100% improvement from baseline in Psoriasis Area and Severity Index
Fecha de la última revisión: 2019 M08 19