Ixekizumab Yields Early, Sustained Improvements to Quality of Life Measures in Pediatric Patients With Plaque Psoriasis

Image Credit: © SNAB - stock.adobe.com

A recent study, presented in a poster at the 2024 Society for Pediatric Dermatology Annual Meeting in Toronto, ON, found that treatment with ixekizumab led to early and sustained improvements to measures of quality of life in pediatric patients with moderate to severe plaque psoriasis.¹

The poster, compiled utilizing data from the IXORA-PEDS (NCT03073200) trial,² shed light on the long-term effects of treatment with ixekizumab in young patients, specifically analyzing its role in pivotal measures of health-related quality of life, such as Children's Dermatology Life Quality Index (CDLQI) and Dermatology Life Quality Index (DLQI) responses.

The CDLQI measures the impact of psoriasis on symptoms and feelings, leisure activities, school or holidays, personal relationships, sleep, and treatment. Similarly, the DLQI assesses the effects on symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment experiences.

The study specifically analyzed responses in each domain of the CDLQI and DLQI, providing a comprehensive understanding of how ixekizumab influences various aspects of daily living for affected children and adolescents with moderate to severe plaque psoriasis.

Background and Methods

IXORA-PEDS was a multicenter, double-blind, randomized, placebo-controlled, phase 3 study conducted over 108 weeks. The trial enrolled 171 patients aged 6 to less than 18 years, all diagnosed with moderate to severe plaque psoriasis. Participants were randomized in a 2:1 ratio to receive either ixekizumab (weight-based dosing every 4 weeks) or a placebo for the first 12 weeks. This initial phase was followed by maintenance and extension periods with ixekizumab through week 108.

The CDLQI and DLQI were used to assess quality of life in patients aged 6-16 years and those aged 17 years or older, respectively. Scores range from 0 to 30, with higher scores indicating a greater impact on quality of life.

Researchers collected quality of life data at multiple time points, including baseline, week 4, and every subsequent follow-up visit through week 108. The primary outcome measures were changes in domain-specific scores from baseline to week 108.

Of the 171 patients enrolled, 115 were randomized to the ixekizumab group and 56 to the placebo group. Among the 166 patients who entered the maintenance and extension periods, 139 (83.7%) completed the study through week 108. At baseline, 79.8% of the participants were aged 12 years or older.

Findings

Significant improvements in quality of life were observed as early as week 4 of the study. By this time, patients treated with ixekizumab reported reductions in CDLQI and DLQI scores across all domains. Specifically, the average decrease in the CDLQI symptoms and feelings domain was -1.76 (0.20), while the DLQI symptoms and feelings domain showed an average decrease of -1.80 (0.28).

Over the 108-week period, these improvements continued to progress. By week 108, the largest decrease from baseline in the CDLQI was seen in the leisure domain, with an average decrease of -2.19 (0.43). In the DLQI, the most significant reduction occurred in the symptoms and feelings domain, with an average decrease of -2.20 (0.53).

Furthermore, the study highlighted that ixekizumab provided early and sustained improvements in quality of life for pediatric patients. These benefits were consistent across all domains of the CDLQI and DLQI.

Conclusions

The IXORA-PEDS trial demonstrates that ixekizumab significantly enhances the quality of life in pediatric patients with moderate to severe plaque psoriasis, according to poster authors Pinter et al.

References

1. Pinter Al, Bobonich M, Swanson E, et al. Children's Dermatology Life Quality Index responses in pediatric patients with moderate-to-severe plaque psoriasis treated with ixekizumab over a 2-year period - results from the randomized IXORA-PEDS trial. Poster presented at the 2024 Society for Pediatric Dermatology Annual Meeting, July 11-14; Toronto, ON.
2. Paller AS, Seyger MMB, Magariños GA, et al. Long-term efficacy and safety of up to 108 weeks of ixekizumab in pediatric patients with moderate to severe plaque psoriasis: The IXORA-PEDS randomized clinical trial [published correction appears in JAMA Dermatol. 2022 Oct 1;158(10):1221. doi: 10.1001/jamadermatol.2022.3698]. JAMA Dermatol. 2022;158(5):533-541. doi:10.1001/jamadermatol.2022.0655