Clinical efficacy, drug retention and recurrence of ixekizumab across psoriasis severities: a multicenter retrospective analysis of 354 patients

This study aims to evaluate the clinical efficacy, recurrence rate, and drug retention rate of plaque psoriasis with different severity levels treated with Ixekizumab. A retrospective, multicenter, real-world study was conducted using the China Cathay database to analyze 354 Chinese patients with mild-to-moderate and severe psoriasis who received ixekizumab therapy. Psoriasis Area and Severity Index (PASI) 75/90/100 response rates, absolute PASI values, 3-year drug retention, and recurrence rates were assessed at 2, 4, 12, 24, and 52 weeks. The baseline PASI scores for the mild-to-moderate group (PASI <10) and severe group (PASI ≥ 10) were 5.6± 2.6 and 20 ± 11, respectively. Except for a difference in the proportion of male patients, there were no differences between the two groups in terms of age,duration of illness, hypertension, hyperlipidemia, cardiovascular diseases, gout and arthropathy. The mild-moderate group showed superior PASI75/90 responses at most timepoints and consistently higher PASI100 rates (all p < 0.05). Absolute PASI values were lower in mild-moderate patients at all timepoints except PASI90 (2/12 weeks) and PASI75 (24 weeks). Severe patients had longer 3-year drug retention (p = 0.007), while recurrence rates were comparable. Ixekizumab demonstrates superior efficacy in mild-moderate versus severe psoriasis, suggesting greater benefit with early biologic intervention.