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Background  Continuous treatment is recommended for patients with moderate‐to‐severe psoriasis; however, treatment may need to be interrupted in routine clinical practice.    Objective  To assess outcomes in patients continuously treated with ixekizumab versus those who interrupted therapy and were subsequently retreated with ixekizumab ( IXE ).    Methods  This analysis used data pooled from two phase 3 trials,  UNCOVER ‐1 and  UNCOVER ‐2. Patients were randomized to placebo ( PBO ),  IXE  every 4 (Q4W) or  IXE  every 2 weeks (Q2W) for 12 weeks. Patients with a static Physician's Global Assessment ( sPGA ) 0, 1 at Week 12 were rerandomized to  IXEQ 4W,  IXE  every 12 weeks (not presented) or  PBO . We examined outcomes in patients who were continuously treated ( IXEQ 2W/ IXEQ 4W;  IXEQ 4W/IXEQ4W) or withdrawn ( IXEQ 2W/ PBO ;  IXEQ 4W/ PBO ), and in patients who were withdrawn and retreated with  IXEQ 4W for 24 weeks after disease relapse ( sPGA  ≥3).    Results  A total of 1226 treated patients achieved an  sPGA  0, 1 at Week 12 and entered the maintenance phase; of these patients, 402 and 416 were rerandomized to  PBO  and  IXEQ 4W, respectively. Among patients interrupting treatment, 157 (82.2%) of  IXEQ 4W/ PBO  and 176 (83.4%) of  IXEQ 2W/ PBO  had an  sPGA  ≥3 by Week 60; median time to relapse was approximately 20 weeks irrespective of induction dose. At Week 60, continuously treated patients maintained high levels of  PASI  and  sPGA  responses (90.0%  PASI  75  IXEQ 2W/IXEQ4W; 81.9%  sPGA  0, 1  IXEQ 2W/IXEQ4W, non‐responder imputation). After 24 weeks of retreatment with  IXEQ 4W ( IXEQ 2W/ PBO /IXEQ4W and  IXEQ 4W/ PBO /IXEQ4W), 87.0% (107 of 123) and 95.1% (97 of 102) (observed), respectively, of patients recaptured  PASI  75 and 70.7% (104 of 147) and 82.3% (107 of 130) (observed) recaptured an  sPGA  0, 1. Overall, adverse events in continuously treated and retreated patients were comparable.    Conclusion  High levels of response were sustained with continuous ixekizumab treatment through 60 weeks. Most patients who were withdrawn experienced disease relapse, and most of those patients recaptured response after 24 weeks of retreatment.

Continuous dosing versus interrupted therapy with ixekizumab: an integrated analysis of two phase 3 trials in psoriasis