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Observational Study
. 2025 Jul 22;11(3):e005806.
doi: 10.1136/rmdopen-2025-005806.

Effectiveness of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis: a nationwide cohort study

Kasper Yde Jensen #  1 , Kathrine Lederballe Grøn #  1   2 , Merete Lund Hetland  1   3 , Bente Glintborg  4   3
Affiliations
Observational Study

Effectiveness of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis: a nationwide cohort study

Kasper Yde Jensen et al. RMD Open. .

Erratum in

Abstract

Objectives: To explore real-world effectiveness of ixekizumab in Danish patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).

Methods: Observational cohort study based on data from the Danish nationwide quality registry, DANBIO. Patients with axSpA and PsA initiating ixekizumab (an interleukin 17 inhibitor (IL-17i)) between 2017 and 2024 were included. Outcomes were 6-, 12- and 24-month retention rates and low disease activity (LDA)/remission after 6 months (axSpA: Axial Spondyloarthritis Disease Activity Score (ASDAS) <2.1/<1.3, PsA: Disease Activity index for Psoriatic Arthritis (DAPSA28) ≤14/≤4, respectively). Clinical factors associated with retention were explored (multivariable Cox regression analyses with adjusted HRs (aHRs)).

Results: 709 patients were included (axSpA: 231, PsA: 478). Most patients were bio-experienced (axSpA: 97%, PsA: 91%). The 6-, 12- and 24-month retention rates were for axSpA: 69% (95% CI 63; 76), 53% (46; 60) and 40% (33; 49); for PsA: 75% (71; 79), 63% (58; 67) and 51% (46; 57), respectively. Patients previously treated with another IL-17i (axSpA 36%, PsA 34%) had an increased risk of withdrawal (aHR: axSpA 1.48 (1.01; 2.17), PsA 2.38 (1.79; 3.15)). Smoking, radiographic status (axSpA) or concomitant methotrexate (PsA) were not associated with withdrawal. After 6 months, 24% of axSpA patients had ASDAS-LDA, and 5% were in ASDAS-remission. For PsA, DAPSA28-LDA was achieved in 43% and DAPSA28-remission in 10%, respectively.

Conclusion: In this nationwide observational study, ixekizumab was primarily prescribed in patients who had failed multiple biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), including other IL-17i. Retention rates were somewhat lower for axSpA than for PsA. For both axSpA and PsA, prior IL-17i treatment was associated with an increased risk of withdrawal, yet the relatively high retention rate and improvement in all disease activity outcomes suggest ixekizumab as a viable option for patients with multiple b/tsDMARD failures.

Keywords: Axial Spondyloarthritis; DMARD; Interleukin-17; Psoriatic Arthritis; Treatment.

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Conflict of interest statement

Competing interests: KYJ: none declared. KLG: none declared. MLH: research grant (paid to institution): AbbVie, BMS, Eli Lilly, MSD, Pfizer and Sandoz, Novartis, UCB; speaker’s fee (paid to institution): Medac, Pfizer and Sandoz. Speaker’s fee (personal): Novartis. BG: research grants (paid to institution): Pfizer, AbbVie, Sandoz, BMS and Eli Lilly. Chairs the DANBIO steering committee.

Figures

Figure 1
Figure 1. (A) Ixekizumab 24-month treatment retention in patients with axSpA. Kaplan-Meier analysis stratified according to previous IL-17i. (B) Ixekizumab 24-month treatment retention in patients with axSpA. Multivariable Cox regression analysis, Model A. axSpA, axial spondyloarthritis; IL-17i, interleukin 17 inhibitor.
Figure 2
Figure 2. (A) Ixekizumab 24-month treatment retention in patients with PsA. Kaplan-Meier analysis stratified according to previous treatment with IL-17i. (B) Ixekizumab 24-month treatment retention in patients with PsA. Multivariable Cox regression analysis, Model A. IL-17i, interleukin 17 inhibitor; PsA, psoriatic arthritis.
Figure 3
Figure 3. Low disease activity and remission at baseline and 6 months of ixekizumab treatment in patients with axSpA and PsA. Proportions shown for patients on drug. axSpA, axial spondyloarthritis; ASDAS, Axial Spondyloarthritis Disease Activity Score; DAPSA28, Disease Activity index for Psoriatic Arthritis; LDA, low disease activity; PsA, psoriatic arthritis.
See this image and copyright information in PMC

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