713 The association between disease severity at time of retreatment and probability of recapture in psoriasis patients receiving ixekizumab

Abstract

Psoriasis patients may interrupt their treatment for different reasons (e.g. infection, planned surgery, non-compliance). Evidence from Phase 3 clinical trials of biologic and non-biologic systemic therapies indicates that responding patients who are withdrawn from therapy have a reduced probability of recapturing the initial response with retreatment. No consistent methodologies have been used to study withdrawal and retreatment, and there is no guidance on how or when to retreat following treatment interruption. We previously reported a high rate of recapture with ixekizumab (IXE) among patients who were static Physician Global Assessment (sPGA) (0,1) responders and who were withdrawn and retreated when disease worsened to an sPGA≥3 in UNCOVER-1 and 2. We expand the analysis here by looking at recapture of response according to degree of disease worsening at the time of retreatment. We analyzed Week 12 sPGA (0,1) responders who received IXE 80mg every two weeks who were re-randomized to placebo and retreated when disease worsened to sPGA≥3 with IXE Q4W (N=176). We calculated recapture response rates in patients who lost PASI 50 (N=67), patients who lost PASI 75 but not PASI 50 (N=82) and patients who lost PASI 90 but not PASI 75 (N=27). In patients who lost PASI 50 at the time of retreatment, PASI 90 was obtained by 68.7% and PASI 100 by 41.8% . In patients who had PASI 50-75, PASI 90 was attained by 76.8% and PASI 100 by 45.1%. In patients who had a PASI 75-90, PASI 90 was obtained by 81.5% and PASI 100 by 51.9% . These data suggest that lower disease severity at time of retreatment results in better recapture of response with IXE.