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Background  Biologics are effective for the treatment of psoriasis. However, treatment outcomes may differ among biologic‐naive patients and those switched from previous biological therapies.    Objectives  The study's objective was to investigate efficacy and safety of ixekizumab, a high‐affinity anti‐interleukin‐17A antibody, in patients with psoriasis with and without previous exposure to biologics.    Methods  Data were integrated from the 12‐week induction phase of two etanercept‐controlled Phase  III  trials. Patients received 80 mg ixekizumab every 2 weeks ( IXE  Q2W;  N  = 736) or every 4 weeks ( IXE  Q4W;  N  = 733) following a 160‐mg starting dose, or placebo ( N  = 361). Etanercept (50 mg twice weekly;  N  = 740) was administered as active control. Psoriasis Area and Severity Index ( PASI ) 75,  PASI  90 and  PASI  100 response rates at week 12 were evaluated in patients with or without previous exposure to biologics. Treatment effects were analysed with the Cochran–Mantel–Haenszel test stratified by study; missing values were imputed as non‐response.    Results  Overall, 497 (19.3%) patients had prior exposure to biologics and 2073 (80.7%) were naive to biologic therapy.  PASI  75 was achieved by 91.5% of biologic‐experienced patients and 87.7% of biologic‐naive patients for  IXE  Q2W, 76.2% and 82.2% for  IXE  Q4W, respectively, and 34.6% and 50.7%, respectively, for etanercept. Higher response rates favouring each ixekizumab dose over etanercept within subgroups were also seen regarding  PASI  90 and  PASI  100.    Conclusions  Contrary to etanercept, the efficacy of ixekizumab was similarly high in patients with and without previous exposure to biologics when administered 80 mg every 2 weeks.

journal of the european academy of dermatology and venereology

Treatment outcomes with ixekizumab in patients with moderate‐to‐severe psoriasis who have or have not received prior biological therapies: an integrated analysis of two Phase  III  randomized studies