Drug safety evaluation of ixekizumab for psoriasis: a review of the current knowledge

Abstract

ABSTRACT Introduction Since Anti-IL-17s availability, concerns about their safety have been raised due to the inhibition of physiological activities that IL-17A plays in the immune response against infections. Ixekizumab is a humanized monoclonal antibody specifically targeting IL-17A approved for the treatment of moderate-to-severe psoriasis. Areas covered The aim of this review is to evaluate the safety profile of ixekizumab in moderate-to-severe psoriasis patients. A compressive literature review has included articles since March 2022. Expert opinion In our analysis, most of the reported AEs were mild or moderate and rarely required treatment discontinuation. Among the class-specific AEs to consider during ixekizumab treatment, there are the risk of Candida infections and the risk of IBD, both of which were reported more frequently than placebo or other biologics (etanercept, ustekinumab, and guselkumab). However, the reported candidiasis resulted in mild-to-moderate and easily managed. The risk of IBD (both exacerbation and de novo diagnosis) represents a class effect of IL-17 inhibitors, which should be well evaluated before considering starting ixekizumab treatment. The most common AEs were represented by nasopharyngitis, upper respiratory tract infection, and injection-site reactions. The analyzed studies confirmed the favorable safety profile of ixekizumab even in more recently published studies.