Ixekizumab (Taltz) for the treatment of psoriasis

Ixekizumab is available in ready-to-use injection pens at a dose of 80 mg.

In moderate or severe plaque psoriasis, a dose of 160 mg is injected under the skin once in the first week of treatment. During the following 12 weeks, 80 mg of ixekizumab are injected every two weeks. After that, one dose of 80 mg is used per month.

For the treatment of psoriatic arthritis, ixekizumab is initially injected once at a dose of 160 mg and then once a month at a dose of 80 mg.

If both conditions occur together, ixekizumab is used in the same way as it is for the treatment of plaque psoriasis.

Patients can also inject themselves after being instructed how to do so by a doctor. The success of the treatment needs to be assessed regularly. If there is no improvement after 16 to 20 weeks people are usually advised to stop the treatment.

For people with moderate to severe plaque psoriasis who are able to have systemic therapy, phototherapy is an option, as well as the drugs fumaric acid ester, ciclosporin, or methotrexate.

If these treatments were unsuccessful or are not suitable, the alternative options include treatment with biological drugs such as adalimubab or infliximab or with the drug ustekinumab.

For people with active psoriatic arthritis, the following treatments are options:

• People whose condition is not expected to get worse quickly, and who have had previous treatment with a single conventional DMARD that wasn’t effective enough or could not be tolerated, can switch to either a different conventional DMARD such as methotrexate or leflunomide or to a combination of the two drugs.
• For people who do not benefit enough from these conventional medications, a biological drug in combination with methotrexate is an option. If methotrexate isn’t well tolerated, the biological drug can be used on its own.
• For people with psoriatic arthritis, switching to a different biological drug in combination with methotrexate is an option if a biologic drug used alone or in combination therapy wasn’t effective enough or wasn't well tolerated. In this case too, the biological drug can be used alone if methotrexate isn't well tolerated.

The Institute for Quality and Efficiency in Health Care (IQWiG, Germany) last looked into whether ixekizumab offers any advantages or disadvantages when compared with the standard treatments in 2018.

The manufacturer provided suitable data for the following groups:

• Adults with moderate to severe plaque psoriasis who didn't benefit enough from systemic treatment or were unable to have it.
• Adults with moderate to severe plaque psoriasis who are able to have systemic treatment.
• Adults with active psoriatic arthritis who no longer benefit enough from a previous treatment with conventional DMARDs and who are able to have treatment with biological drugs.

This information summarizes the main results of reviews produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The reviews were commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of these reviews and the hearings received, the G-BA passed a resolution on the added benefit of ixekizumab (Taltz) for the treatment of plaque psoriasis and active psoriatic arthritis.