RMD Open

IL-7 inhibitor shows real-world durability in axial spondyloarthritis, psoriatic arthritis

August 4, 2025

Study details: This nationwide Danish cohort study evaluated 709 patients with axial spondyloarthritis (axSpA; n=231) or psoriatic arthritis (PsA; n=478) initiating ixekizumab between 2017 and 2024. Most were biologic-experienced (axSpA: 97%, PsA: 91%), and over one-third had prior IL-17 inhibitor exposure. Outcomes included drug retention at 6, 12, and 24 months, and disease activity at 6 months using ASDAS (Ankylosing Spondylitis Disease Activity Score) for axSpA and DAPSA28 (28-joint Disease Activity in Psoriatic Arthritis) for PsA. Low disease activity (LDA) and remission thresholds were predefined.

Results: At 12 months, ixekizumab retention was 53% in axSpA and 63% in PsA; by 24 months, rates declined to 40% and 51%, respectively. Prior IL-17i use significantly increased withdrawal risk (adjusted hazard ratio: axSpA 1.48; PsA 2.38). At 6 months, 24% of axSpA patients achieved ASDAS-LDA and 5% reached remission. Among PsA patients, 43% achieved DAPSA28-LDA and 10% remission. Smoking, radiographic status (axSpA), and methotrexate use (PsA) weren’t associated with retention.

Clinical impact: Although most patients with axSpA or PsA didn’t achieve low disease activity or remission, a substantial minority did—particularly among those with PsA. These real-world findings suggest that ixekizumab remains a viable option for patients with refractory disease, even after prior IL-17 inhibitor failure, and may yield meaningful benefit in select cases.

Source:

Jensen KY, et al. (2025, July 22). RMD Open. Effectiveness of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis: a nationwide cohort study. https://pubmed.ncbi.nlm.nih.gov/40701624/