scholarly journals Number needed to treat for interleukin inhibitors approved for the treatment of moderate-to-severe plaque psoriasis in Italy

2021 ◽  
Vol 8 ◽  
pp. 53-57
Author(s):  
Roberto Ravasio ◽  
Antonio Costanzo ◽  
Silvia Antonelli ◽  
Alessia Maiorino ◽  
Serena Losi
Keyword(s):  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Severity Index ◽  
Number Needed To Treat ◽  
Severe Plaque Psoriasis ◽  
Cochrane Database ◽  
Biological Treatments ◽  
Effective Option ◽  
Interleukin Inhibitors ◽  
Systemic Therapies

Background: Interleukin (IL) inhibitors achieve greater levels of efficacy than older systemic therapies. We calculated the number needed to treat (NNT) of ixekizumab compared with other IL inhibitors approved in Italy for the treatment of moderate-to-severe plaque psoriasis. Methods: The clinical efficacy was evaluated in terms of NNT, based on the results of a recent network meta-analysis (NMA) by the Cochrane Database of Systematic Reviews. The NMA investigated many systemic and biological treatments, but this analysis compared only the efficacy of the following IL inhibitors – brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab – for patients with moderate-to-severe plaque psoriasis. Drugs were compared and ranked according to effectiveness considering the PASI (Psoriasis Area and Severity Index) 90 score. Results: One-hundred and forty trials (51,749 patients) were included in the NMA. Considering the proportion of patients who achieve PASI90, ixekizumab showed the lowest NNT among all comparators (ixekizumab 2.01 [2.46-3.00]; risankizumab 2.05 [2.50-3-05]; guselkumab 2.16 [2.68-3.36]; secukinumab 2.40 [2.90-3.51]; brodalumab 2.61 [3.18-3.88]; ustekinumab 3.44 [4.12-4.95]; tildrakizumab 3.10 [4.15-5.59]. Conclusion: The findings show that ixekizumab is the most effective option (NNT) for the treatment of moderate-to-severe plaque psoriasis.

Placebo Response in Phase 3 Trials of Systemic Therapies for Moderate-to-Severe Plaque Psoriasis: A Systematic Review and Meta-Analysis

Dermatology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Danni Ambikaibalan ◽  
Anna Sophie Quaade ◽  
Anne-Sofie Halling ◽  
Jacob P. Thyssen ◽  
Alexander Egeberg
Keyword(s):  
Systematic Review ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Placebo Response ◽  
Phase 3 ◽  
Severe Plaque Psoriasis ◽  
Systemic Therapies

Efficacy of Brodalumab for Moderate to Severe Plaque Psoriasis: A Canadian Network Meta-Analysis

2020 ◽  
Vol 24 (6) ◽  
pp. 561-572
Author(s):  
Weiguang Xue ◽  
Paranjoy Saharia ◽  
Emma Gray ◽  
Shoghag Khoudigian-Sinani ◽  
Véronique Gaudet ◽  
...  
Keyword(s):  
Relative Risk ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Credible Interval ◽  
Severity Index ◽  
Biologic Agents ◽  
Sensitivity Analyses ◽  
Induction Phase ◽  
Significant Heterogeneity ◽  
Severe Plaque Psoriasis

Background Several treatments for plaque psoriasis are available, but it remains challenging for physicians to make informed treatment decisions due to a lack of head-to-head trials. Objectives This network meta-analysis (NMA) compares the efficacy of brodalumab to other biologic agents in Canada for moderate-to-severe plaque psoriasis. Methods A systematic literature review of randomized controlled trials (RCTs) published before October 2017 was conducted to populate the NMA. Comparators included etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, guselkumab, and placebo. The primary outcome was the psoriasis area and severity index (PASI) response at the end of induction phase. A random effects Bayesian multinomial likelihood and probit link model analyzed PASI 75, 90, and 100 responses. Inconsistency and heterogeneity were assessed. Sensitivity analyses were conducted to explore potential effect modifiers like baseline PASI score, age, and weight. Results A total of 43 RCTs were included. Brodalumab 210 mg had significantly better PASI response than etanercept, ustekinumab, adalimumab, secukinumab, and guselkumab and comparable responses to infliximab and ixekizumab. Relative risk of PASI 90 response for brodalumab varied from 2.84 (95% credible interval [CrI]: 2.35-3.52, P < .05) to 0.99 (95% CrI: 0.88-1.11, ns) compared to etanercept and ixekizumab. This was similar across PASI 75 responses, but a larger relative risk between brodalumab and all comparators except ixekizumab was observed for PASI 100. No significant heterogeneity or inconsistencies were identified. The results were consistent across sensitivity analyses, indicating robustness of the results. Conclusion Brodalumab 210 mg has efficacy superior to most biologic agents for moderate-to-severe plaque psoriasis in Canada.

scholarly journals Newer Biologics for the Treatment of Plaque Psoriasis

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Anusree Subramonian ◽  
Melissa Walter
Keyword(s):  
Side Effects ◽  
Systematic Reviews ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Severe Plaque Psoriasis ◽  
Meta Analyses

Eight systematic reviews with network meta-analysis were identified that compared newer biologics with older biologics in patients with moderate-to-severe plaque psoriasis. There was extensive overlap of primary studies across the systematic reviews and network meta-analyses. Newer biologics such as secukinumab, ixekizumab, brodalumab and risankizumab were more favourable compared to older biologics (adalimumab, etanercept, and ustekinumab) in reaching 90% or 100% skin clearance, as measured with the Psoriasis Area Severity Index. The risk of side effects was similar between the newer and older biologics.

scholarly journals Model-Based Meta-Analysis in Psoriasis: A Quantitative Comparison of Biologics and Small Targeted Molecules

2021 ◽  
Vol 12 ◽  
Author(s):  
Huan He ◽  
Wenwen Wu ◽  
Yi Zhang ◽  
Meng Zhang ◽  
Ning Sun ◽  
...  
Keyword(s):  
Response Time ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Severity Index ◽  
Index Score ◽  
Longitudinal Models ◽  
End Points ◽  
Severe Plaque Psoriasis ◽  
Severity Index Score ◽  
Systemic Agents

Background: The response time-course information of biologics and small targeted molecules for the treatment of moderate to severe plaque psoriasis which helps clinicians to understand the onset of action and maintenance of effect are unclear. Quantitative information about the efficacy comparation of different systemic agents are needed.Methods: Model-based meta-analysis was conducted and longitudinal models were developed by applying two clinical end points commonly reported in the clinical trials of psoriasis: the proportion of patients achieving ≥75% reduction from baseline Psoriasis Area and Severity Index score (PASI75) and the proportion of patients achieving ≥90% reduction from baseline Psoriasis Area and Severity Index score (PASI90).Results: A total of 80 trials of thirteen biological agents and four small targeted molecules covering 235 treatment arms and 40323 patients with moderate to severe plaque psoriasis were included in this analysis. The drugs were divided into five classes of biologics and three classes of small molecules. Two longitudinal models of PASI75 and PASI90 were used to describe the time-varying drug effect and dose-effect relationship. The typical response-time courses for PASI75 and PASI90 increased over time and finally reached to the platform. For PASI75 end point at week 12, of all the therapeutic drugs, risankizumab administered as 150 mg at week 0, week 4, and q12w showed the most efficacious with PASI75 was 85.95% (95%CI, 75.71–92.60%), followed by ixekizumab administered as 160 mg at week 0, and q4w with PASI75 was 85.9% (95%CI, 76.12–92.79%). As for PASI90 end point at week 12, ixekizumab 160 mg at week 0, and q4w showed the greatest percentage of person achieved PASI90 (67.2%; 95%CI, 49.91–77.2%), followed by risankizumab 150 mg at week 0, week 4, and q12w (65.5%; 95%CI, 47.8–75.7%). What’s more, the risankizumab provided the highest response of PASI90 at week 16 and week 24.Conclusions: This study provided a quantitative efficacy comparation of 17 systemic agents for psoriasis in term of efficacy only and that safety was not considered. Risankizumab and ixekizumab showed superiority for both the two end points.

PBI3 Comparative Efficacy of Bimekizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Network Meta-Analysis

2021 ◽  
Vol 24 ◽  
pp. S14
Author(s):  
A. Armstrong ◽  
K. Reich ◽  
R.B. Warren ◽  
V. Taieb ◽  
K. Fahrbach ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Comparative Efficacy ◽  
Severe Plaque Psoriasis

Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis

2019 ◽  
Vol 54 (4) ◽  
pp. 380-387 ◽  
Author(s):  
Wendy Li ◽  
Rima Ghamrawi ◽  
Wasim Haidari ◽  
Steven R. Feldman
Keyword(s):  
Clinical Trials ◽  
Phase Ii ◽  
Plaque Psoriasis ◽  
Data Extraction ◽  
Severity Index ◽  
Phase Iii ◽  
Cochrane Library ◽  
Severe Plaque Psoriasis ◽  
Phase Iii Clinical Trials ◽  
Interleukin 23

Objective: Risankizumab (Skyrizi), an interleukin-23 (IL-23) antagonist, was approved by the Food and Drug Administration (FDA) for the treatment of moderate to severe plaque psoriasis in April 2019. This article will review phase II and III clinical trials to assess the efficacy, safety, and clinical application of this drug. Data Sources: A systematic literature review was performed using the terms “psoriasis AND risankizumab” in the OVID MEDLINE, PubMed, Cochrane Library, EMBASE, and Web of Science databases. ClinicalTrials.gov was searched to identify ongoing or nonpublished studies. Study Selection and Data Extraction: Articles written in English between January 2000 and October 2019 discussing phase II and phase III clinical trials were evaluated. Data Synthesis: By the primary end point at week 16 in phase III trials, more patients achieved Psoriasis Area and Severity Index 90 receiving 150 mg risankizumab (72%-75%) compared with placebo (2.0%-4.9%, P < 0.001), 45 or 90 mg ustekinumab (42.0%-48%, P < 0.0001), and 40 mg adalimumab (47%, P < 0.0001). More patients achieved a static Physician’s Global Assessment score of 0 or 1 receiving 150 mg risankizumab (84%-88%) compared with placebo (5.1%-7.8%, P < 0.001), 45 or 90 mg ustekinumab (62%-63%, P < 0.0001), and 40 mg adalimumab (60%, P < 0.0001). Risankizumab was well tolerated across all studies. Conclusion: Risankizumab is a newly FDA-approved IL-23 inhibitor that shows particular promise in the treatment of plaque psoriasis. Based on this review, it is an effective and safe addition to the armamentarium of biologics that are currently available.

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