Matching-Adjusted Indirect Comparison of Efficacy in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Ixekizumab Versus Secukinumab

Abstract

Background

Head-to-head randomised studies comparing ixekizumab and secukinumab in the treatment of psoriasis are not available.

Objective

Assess efficacy and quality of life with ixekizumab vs. secukinumab treatment using matching-adjusted indirect comparisons.

Methods

Psoriasis Area and Severity Index (PASI) improvement of at least 75%, 90% and 100% and Dermatology Life Quality Index (DLQI) 0/1 response rates for approved doses of ixekizumab (160 mg at Week 0, then 80 mg every two weeks for the first 12 weeks) and secukinumab (300 mg at Weeks 0, 1, 2, 3 and 4, then 300 mg every 4 weeks) treatment were compared using data from active (etanercept and ustekinumab) and placebo-controlled studies. Comparisons were made using the Bucher (BU) and two modified versions of the Signorovitch method (SG total and SG separate). Subsequently, results based on active treatment common comparators were combined using generic inverse-variance meta-analysis.

Results

In meta-analysis of studies with active comparators, PASI 90 response rates were 12.7% (95% CI: 5.5%-19.8%; p=0.0005), 10.0% (2.1%-18.0%; p=0.01) and 11.2% (3.2%-19.1%; p=0.006) higher and PASI 100 response rates 11.7% (5.9%-17.5%; p<0.001), 12.7% (6.0%-19.4%; p<0.001) and 13.1% (6.3%-19.9%; p<0.001) higher for ixekizumab compared to secukinumab using BU, SG total and SG separate methods. PASI 75 results were comparable when SG methods were used and in favor of ixekizumab using BU method. Week 12 DLQI 0/1 response rates did not differ significantly.

Conclusion

Ixekizumab had higher PASI 90 and PASI 100 responses at Week 12 compared to secukinumab using adjusted indirect comparisons.

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