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Comparison of cumulative clinical benefits of biologics for the treatment of psoriasis over 16 weeks: Results from a network meta-analysis - 14/04/20

Doi : 10.1016/j.jaad.2019.12.038 
Richard B. Warren, MD, PhD a, Melinda Gooderham, MD b, Russel Burge, PhD c, d, , Baojin Zhu, PhD c, David Amato, DO c, Karen Huayu Liu, PhD c, David Shrom, PhD c, Jiaying Guo, MS c, Alan Brnabic, MSc c, Andrew Blauvelt, MD, MBA e
a Salford Royal NHS Foundation Trust, The University of Manchester, National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom 
b SKiN Centre for Dermatology, Peterborough, Ontario, Canada 
c Lilly Corporate Center, Indianapolis, Indiana 
d University of Cincinnati 
e Oregon Medical Research Center, Portland, Oregon 

Correspondence and reprint requests to: Russel Burge, PhD, Eli Lilly and Company, Lilly Corporate Center DC 1532, Indianapolis, IN, 46285.Eli Lilly and CompanyLilly Corporate Center DC 1532IndianapolisIN46285

Abstract

Background

Cumulative clinical improvement and speed of improvement are important to psoriasis patients.

Objective

Compare cumulative benefits of biologics over 12 to 16 weeks in the treatment of moderate to severe psoriasis.

Methods

A systematic literature review identified phase III trial data on Psoriasis Area and Severity Index (PASI) responses for biologics during 12 and 16 weeks of treatment. Cumulative clinical benefit, measured by the area under the curve for PASI ≥75% improvement (PASI 75), ≥90% improvement (PASI 90), and 100% improvement (PASI 100), was compared using the network meta-analysis and Bayesian methodology on the relative probability of achieving percentage of maximum area under the curve.

Results

Among biologics approved for psoriasis treatment, anti–interleukin-17 biologics demonstrated consistently greater cumulative clinical benefits on PASI 75, PASI 90, and PASI 100 over the 12- or 16-week period than anti–interleukin-23 and other biologics. For biologics with 12-week data, ixekizumab and brodalumab showed greater cumulative benefits for PASI 75, PASI 90, and PASI 100 than secukinumab, followed by guselkumab, infliximab, adalimumab, ustekinumab, and etanercept. Ixekizumab showed greater cumulative benefits than all other biologics reporting 16-week data.

Limitations

Recently approved biologics were not included.

Conclusion

Ixekizumab (at 12 weeks and 16 weeks) and brodalumab (at 12 weeks) had greater cumulative clinical benefit than all of other biologics studied.

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Key words : area under the curve, biologics, cumulative benefit, ixekizumab, meta-analysis, psoriasis

Abbreviations used : AUC, IL, NMA, PASI, PASI 75, PASI 90, PASI 100, Q2W, Q4W, Q8W, Q12W, SLR, TNF-α


Plan


 Funding sources: Eli Lilly and Company.
 Conflicts of interest: Warren has served as an advisor, clinical investigator, or both, for AbbVie, Almirall, Boehringer Ingelheim, Celgene, Eli Lilly and Company, GlaxoSmithKline, Janssen, LEO Pharma, Merck Sharp & Dohme, Novartis, Sanofi Genzyme, and UCB Pharma and as a paid speaker for AbbVie, Almirall, Amgen, Celgene, Eli Lilly and Company, Janssen, LEO Pharma, Novartis, Sanofi Genzyme, and UCB Pharma. Dr Gooderham has served as an advisor or clinical investigator, or both, for AbbVie, Amgen, Arcutis, Akros, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Coherus, Dermira Inc, Eli Lilly and Company, Galderma, Genentech/Roche, GlaxoSmithKline, Janssen, Kyowa Kirin, LEO Pharma, Merck Sharp & Dohme, Novartis, Pfizer, Regeneron, Sanofi Genzyme, Sienna Pharmaceuticals, Sun Pharma, UCB Pharma, and Valeant, and as a paid speaker for AbbVie, Amgen, Celgene, Eli Lilly and Company, Janssen, LEO Pharma, Novartis, Pfizer, Regeneron, and Sanofi Genzyme. Russel Burge, Baojin Zhu, Karen Huayu Liu, David Shrom, Jiaying Guo, and Alan Brnabic are employees and stockholders of Eli Lilly and Company. Blauvelt has served as a scientific adviser or clinical study investigator, or both, for AbbVie, Aclaris, Almirall, Arena, Athenex, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant, Dermira Inc, Eli Lilly and Company, FLX Bio, Forte, Galderma, Janssen, LEO Pharma, Novartis, Ortho, Pfizer, Regeneron, Sandoz, Sanofi Genzyme, Sun Pharma, and UCB Pharma, and as a paid speaker for AbbVie.
 IRB approval status: Not applicable.


© 2019  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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P. 1138-1149 - mai 2020 Retour au numéro
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