By Gary M. White, MD
Ixekizumab (brand name Taltz) is a monoclonal antibody that targets interleukin-17A and is highly effective in the treatment of psoriasis.
- When given 80 mg twice monthly in one study, the percent of patients achieving PASI 75 at 12 weeks was 89%, and the percent achieving PASI 100 at 12 weeks was 35%.
- Rates of candidiasis do not seem to be increased compared to placebo.
- Ixekizumab seems to induce a rapid reduction in itch in patients with psoriasis.
- Ixekizumab does equally well in patients with prior exposure to biologics compared with those who are naive [JEADV 2017;31;679].
- High BMI does not diminish efficacy of ixekizumab [JEADV 2017;31;1196].
- Persistently high response rates are seen in studies of 2 years duration [JAAD 2017;77;855].
- Candida infections are among the most common side effects, occurring at a rate of 3.8%.
Ixekizumab is indicated for adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
Dosage and Administration
Administer by subcutaneous injection. The recommended dose is 160 mg (two 80 mg injections) at week 0, followed by 80 mg at weeks 2, 4, 6, 8, 10, and 12, then 80 mg every 4 weeks.
Warnings and Precautions
- Infections: Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
- Tuberculosis (TB): Evaluate for TB prior to initiating treatment.
- Hypersensitivity: If a serious allergic reaction occurs, discontinue Taltz immediately and initiate appropriate therapy.
- Inflammatory Bowel Disease: Crohn’s disease and ulcerative colitis, including exacerbations, occurred during clinical trials. Patients who are treated with Taltz and have inflammatory bowel disease should be monitored closely.
Most common (≥1%) adverse reactions associated with Taltz treatment are injection site reactions, upper respiratory tract infections, nausea, and tinea infections.
Live vaccines should not be given during therapy with ixekizumab.
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