NYMC Faculty Publications
Ixekizumab Treatment Improves Fingernail Psoriasis in Patients With Moderate-to-severe Psoriasis: Results from the Randomized, Controlled and Open-label Phases of UNCOVER-3
Journal Title
Journal of the European Academy of Dermatology and Venereology
First Page
477
Last Page
482
Document Type
Article
Publication Date
March 2017
Department
Dermatology
Abstract
BACKGROUND: Fingernail psoriasis is difficult to treat. OBJECTIVE: The objective was to evaluate the effect of ixekizumab, a monoclonal antibody selectively targeting IL-17A, on fingernail psoriasis. METHODS: This Phase 3, double-blind trial (UNCOVER-3) randomized patients to placebo, etanercept (50-mg twice weekly), or 80 mg ixekizumab as one injection every 4 (IXE Q4W) or 2 weeks (IXE Q2W) after a 160-mg starting dose. At Week 12, ixekizumab patients received open-label IXE Q4W through Week 60; placebo patients received a 160-mg starting ixekizumab dose and etanercept patients a 4-week placebo washout before starting IXE Q4W. Efficacy was assessed by mean per cent Nail Psoriasis Severity Index (NAPSI) improvement at Weeks 12 and 60. RESULTS: Of 1346 patients in the UNCOVER-3 trial, this subgroup analysis included only patients with baseline fingernail psoriasis: 116 (60.1%) placebo, 236 (61.8%) etanercept, 228 (59.1%) IXE Q4W and 229 (59.5%) IXE Q2W. At Week 12, greater mean per cent NAPSI improvements were achieved in IXE Q4W (36.7%) and IXE Q2W (35.2%) vs. placebo (-34.3%, P 80% regardless of initial treatment. At Week 12 (nonresponder imputation), complete resolution (NAPSI = 0) was achieved in 19.7% (IXE Q4W), 17.5% (IXE Q2W), 4.3% (placebo, P 80% regardless of initial treatment. At Week 12 (nonresponder imputation), complete resolution (NAPSI = 0) was achieved in 19.7% (IXE Q4W), 17.5% (IXE Q2W), 4.3% (placebo, P 50% of patients achieved complete resolution. CONCLUSIONS: At Week 12, significant improvements in fingernail psoriasis were achieved with ixekizumab therapy. With IXE Q4W maintenance dosing, additional improvement was demonstrated through 60 weeks, and >50% of patients achieved complete resolution. Registered at clinicaltrials.gov: NCT01646177.
Recommended Citation
van de Kerkhof, P., Guenther, L., Gottlieb, A., Sebastian, M., Wu, J., Foley, P., Morita, A., Goldblum, O., Zhang, L., Erickson, J., Ball, S., & Rich, P. (2017). Ixekizumab Treatment Improves Fingernail Psoriasis in Patients With Moderate-to-severe Psoriasis: Results from the Randomized, Controlled and Open-label Phases of UNCOVER-3. Journal of the European Academy of Dermatology and Venereology, 31 (3), 477-482. https://doi.org/10.1111/jdv.14033
