Ixekizumab associated with improvement in pityriasis rubra pilaris
Ixekizumab may reduce signs and symptoms of pityriasis rubra pilaris in some patients.
A single-arm investigator-initiated trial of adults with moderate to severe pityriasis rubra pilaris (PRP) included 12 patients, of which 11 completed a treatment regimen of ixekizumab: a 160 mg subcutaneous injection at the initial visit followed by 80 mg subcutaneous injections every 2 weeks through week 12 and then 80 mg subcutaneous injections every 4 weeks through week 20.
Taltz (ixekizumab, Eli Lilly and Company) is an FDA-approved psoriasis treatment. It is a humanized monoclonal IgG4 antibody against IL-17A.
“PRP symptoms have major effects on quality of life, and more than half of patients diagnosed with PRP report comorbid depressive symptoms,” the study authors wrote. There are no FDA-approved treatments for PRP.
Patients qualified for the trial, held at a single academic center, if they were diagnosed with moderate to severe PRP by clinical assessment, had a biopsy consistent with PRP and had not previously been treated with any therapeutic agent targeting IL-17.
The primary endpoint was defined as a mean improvement in Psoriasis Area and Severity Index score after 24 weeks, with some of the secondary endpoints including a change in affected body surface area and quality of life.
At 24 weeks, the mean improvement in PASI score was 15.2 (P < .0001), with seven patients (58%) achieving PASI 50 at week 24. PASI 75 was achieved by five patients (42%), and PASI 90 was achieved by two patients (17%).
Affected body surface area had a mean improvement of 29.8% (P = .009). Dermatology Life Quality Index improved an average of 9.5 points (P = .004), with six patients (50%) reporting the disease had no effect on their quality of life.
“The trial showed that ixekizumab is associated with decreased clinical signs and symptoms of PRP in a subset of patients, including those in whom previous other systemic therapies had failed,” the study authors wrote. “Given this condition’s substantial disease burden, such associations should be considered in directing future prescribing patterns.” – by Rebecca L. Forand
Disclosures: Haynes reports receiving grants to his institution from Eli Lily and Company during the conduct of the study. Please see the study for all other authors’ relevant financial disclosures.