Efficacy and safety of ixekizumab in a randomized, double-blinded, placebo-controlled phase IIIb study of patients with moderate-to-severe genital psoriasis

Background Genital psoriasis (GenPs) is a common, debilitating and difficult-to-treat manifestation of plaque psoriasis. However, few controlled, interventional studies of GenPs exist. ObjectivesMethodsTo determine the efficacy of ixekizumab vs. placebo in patients with moderate-to-severe GenPs with 1% involved body surface area (BSA). Patients with moderate-to-severe GenPs, defined as a baseline static Physician's Global Assessment of Genitalia (sPGA-G) score of 3, with BSA 1% were randomized 1 : 1 to receive placebo (n = 74) or the recommended dosing of ixekizumab (n = 75). Major outcomes included the percentage of patients achieving 0 or 1 scores on the sPGA-G (primary end point), overall sPGA, GenPs Sexual Frequency Questionnaire (GenPs-SFQ) item 2, and 3-point improvement from baseline on the GenPs itch numerical rating scale. ResultsConclusionsAt week 12, ixekizumab was superior to placebo for sPGA-G 0/1 (73% vs. 8%, P < 0001), overall sPGA 0/1 (73% vs. 3%, P < 0001), GenPs-SFQ item 2 score of 0 or 1 (78% vs. 21%, P < 0001) and genital itch (60% vs. 8%, P < 0001). No candidiasis was reported, no deaths occurred and one (1%) serious adverse event was reported in a patient receiving placebo. Ixekizumab was superior to placebo for the treatment of moderate-to-severe GenPs with BSA 1%. The safety profile of ixekizumab was consistent with previous studies in moderate-to-severe plaque psoriasis.