TY - JOUR
T1 - Effectiveness of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis
T2 - a nationwide cohort study
AU - Jensen, Kasper Yde
AU - Grøn, Kathrine Lederballe
AU - Glintborg, Bente
AU - Hetland, Merete Lund
N1 - © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
PY - 2025/7/22
Y1 - 2025/7/22
N2 - OBJECTIVES: To explore real-world effectiveness of ixekizumab in Danish patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).METHODS: Observational cohort study based on data from the Danish nationwide quality registry, DANBIO. Patients with axSpA and PsA initiating ixekizumab (an interleukin 17 inhibitor (IL-17i)) between 2017 and 2024 were included. Outcomes were 6-, 12- and 24-month retention rates and low disease activity (LDA)/remission after 6 months (axSpA: Axial Spondyloarthritis Disease Activity Score (ASDAS) <2.1/<1.3, PsA: Disease Activity index for Psoriatic Arthritis (DAPSA28) ≤14/≤4, respectively). Clinical factors associated with retention were explored (multivariable Cox regression analyses with adjusted HRs (aHRs)).RESULTS: 709 patients were included (axSpA: 231, PsA: 478). Most patients were bio-experienced (axSpA: 97%, PsA: 91%). The 6-, 12- and 24-month retention rates were for axSpA: 69% (95% CI 63; 76), 53% (46; 60) and 40% (33; 49); for PsA: 75% (71; 79), 63% (58; 67) and 51% (46; 57), respectively. Patients previously treated with another IL-17i (axSpA 36%, PsA 34%) had an increased risk of withdrawal (aHR: axSpA 1.48 (1.01; 2.17), PsA 2.38 (1.79; 3.15)). Smoking, radiographic status (axSpA) or concomitant methotrexate (PsA) were not associated with withdrawal. After 6 months, 24% of axSpA patients had ASDAS-LDA, and 5% were in ASDAS-remission. For PsA, DAPSA28-LDA was achieved in 43% and DAPSA28-remission in 10%, respectively.CONCLUSION: In this nationwide observational study, ixekizumab was primarily prescribed in patients who had failed multiple biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), including other IL-17i. Retention rates were somewhat lower for axSpA than for PsA. For both axSpA and PsA, prior IL-17i treatment was associated with an increased risk of withdrawal, yet the relatively high retention rate and improvement in all disease activity outcomes suggest ixekizumab as a viable option for patients with multiple b/tsDMARD failures.
AB - OBJECTIVES: To explore real-world effectiveness of ixekizumab in Danish patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).METHODS: Observational cohort study based on data from the Danish nationwide quality registry, DANBIO. Patients with axSpA and PsA initiating ixekizumab (an interleukin 17 inhibitor (IL-17i)) between 2017 and 2024 were included. Outcomes were 6-, 12- and 24-month retention rates and low disease activity (LDA)/remission after 6 months (axSpA: Axial Spondyloarthritis Disease Activity Score (ASDAS) <2.1/<1.3, PsA: Disease Activity index for Psoriatic Arthritis (DAPSA28) ≤14/≤4, respectively). Clinical factors associated with retention were explored (multivariable Cox regression analyses with adjusted HRs (aHRs)).RESULTS: 709 patients were included (axSpA: 231, PsA: 478). Most patients were bio-experienced (axSpA: 97%, PsA: 91%). The 6-, 12- and 24-month retention rates were for axSpA: 69% (95% CI 63; 76), 53% (46; 60) and 40% (33; 49); for PsA: 75% (71; 79), 63% (58; 67) and 51% (46; 57), respectively. Patients previously treated with another IL-17i (axSpA 36%, PsA 34%) had an increased risk of withdrawal (aHR: axSpA 1.48 (1.01; 2.17), PsA 2.38 (1.79; 3.15)). Smoking, radiographic status (axSpA) or concomitant methotrexate (PsA) were not associated with withdrawal. After 6 months, 24% of axSpA patients had ASDAS-LDA, and 5% were in ASDAS-remission. For PsA, DAPSA28-LDA was achieved in 43% and DAPSA28-remission in 10%, respectively.CONCLUSION: In this nationwide observational study, ixekizumab was primarily prescribed in patients who had failed multiple biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), including other IL-17i. Retention rates were somewhat lower for axSpA than for PsA. For both axSpA and PsA, prior IL-17i treatment was associated with an increased risk of withdrawal, yet the relatively high retention rate and improvement in all disease activity outcomes suggest ixekizumab as a viable option for patients with multiple b/tsDMARD failures.
KW - Humans
KW - Arthritis, Psoriatic/drug therapy
KW - Male
KW - Female
KW - Adult
KW - Middle Aged
KW - Denmark/epidemiology
KW - Antibodies, Monoclonal, Humanized/therapeutic use
KW - Axial Spondyloarthritis/drug therapy
KW - Treatment Outcome
KW - Registries
KW - Antirheumatic Agents/therapeutic use
KW - Interleukin-17/antagonists & inhibitors
KW - Severity of Illness Index
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=105011496535&partnerID=8YFLogxK
U2 - 10.1136/rmdopen-2025-005806
DO - 10.1136/rmdopen-2025-005806
M3 - Journal article
C2 - 40701624
SN - 2056-5933
VL - 11
JO - RMD Open
JF - RMD Open
IS - 3
M1 - e005806
ER -