Long-term Clinical Efficacy, Safety, and Drug Survival of Ixekizumab for Patients with Psoriasis in a Real-life Setting.

The effectiveness of ixekizumab in controlling moderate to severe psoriasis has been established by clinical trials. Nevertheless, further research from real-world scenarios is still required. We aimed to assess the long-term efficacy, drug survival, and safety of ixekizumab in the treatment of psoriasis and to determine the factors that could potentially impact the efficacy and drug survival. Patients with psoriasis who initiated ixekizumab treatment underwent follow-up for up to 156 weeks. The effectiveness of the treatment was determined using the Psoriasis Area Severity Index (PASI). The study employed Kaplan-Meier analysis to assess drug survival and utilized Cox regression analysis to analyze predictive factors. The data of 496 patients with moderate-to-severe psoriasis were included in this study. PASI 75/ 90 and 100 rates for the 156th week were found to be 98.1%, 96.2%, and 30.7%, respectively. Palmoplantar involvement was the only factor associated with PASI 100 achievement at the 16th week (OR 3.848, %95 CI: 1.341-11.043, p: 0.012). At 12 months, 24 months, and 36 months, the cumulative drug survival probability rates were 91.6%, 86.8%, and 85.7%, respectively. PASI 90 achievement at the 16th week was associated with a lower rate of discontinuation (HR 4.634, 95% CI (2.073-10.358), P<0.001) while female sex was associated with high rate of discontinuation (HR 2.270, 95% CI (1.081-4.770), P=0.030). Our study indicates rapid, sustainable effectiveness of ixekizumab in psoriasis treatment. Achieving PASI 100 may be challenging for patients with palmoplantar involvement. Achieving PASI 90 by the 16th week is a predictor of longer drug survival.