Invited Faculty
  • Yun-Hong Cheon
    Gyeongsang Nat'l Univ.
    Korea
  • The spondyloarthritides (SpA) comprise related but phenotypically distinct inflammatory diseases including axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). axSpA is defined as a chronic inflammatory disease of the sacroiliac joint and the axial skeleton that may involve other joints, entheses, and can have extra-musculoskeletal manifestations in organs such as intestines, skin, eyes, lung, and heart and then seriously degrade the quality of life.
    Although the pathogenic mechanisms underlying axSpA and PsA are not fully understood, evidences suggest that immune responses mediated by interleukin 17A (IL-17A) play a pivotal role in both diseases. Following the TNF inhibitors that have been prescribed primarily as a treatment for axSpA in Korea, a new IL-17A inhibitor, ixekizumab, has been approved for the reimbursement from October 1st, 2020 in Korea. And ixekizumab is expected to be able to expand the 1st line reimbursement for the biologics-naive paitents with AS in 2023.
    This talk addresses long-term efficacy and safety of ixekizumab in phase III study (SPIRIT H2H) for biologics-naive paitents with active PsA and in COAST-Y, 2 years extension of the COAST-V, -W trials for axSpA, recently published. In SPIRIT H2H trials, Taltz was superior to adalimumab in the percentage of patients who simultaneously achieved ACR50 and PASI100 at week 24 (36%) and sustained up to week 52 (39%). Taltz demonstrated reduction in pain in PsA irrespective of controlled or non-controlled inflammation over 1 year. IL-17A is a mediator of pain processing in both the ascending and descending circuits. Taltz showed significant improvement of spinal pain at night vs PBO in axSpA over week 16 (63.0%) up to week 52 (69.2%). Taltz significantly improved spinal pain at night vs PBO in patients with and without measurable inflammation over 1 year. Most patients treated with ixekizumab for 2 years did not show radiographic progression. There were no unexpected safety signals reported in 3 years extension of SPIRIT study and in COAST-V, -W and COAST-Y trials.
    Ixekizumab, one of the IL-17 inhibitors show efficacy in treating multiple facets of SpA, including psoriasis, enthesitis, synovitis, bone erosion, new bone formation and pain, which indicates the importance of IL-17A in disease pathophysiology. Based on the RCT outcomes of ixekuzumab examined through this lecture, there are expectations as a good treatment option for AS patients after the 1st line reimbursement expansion.
    • Date Time Room Session Title Lecture Title
    May 20 08:00-08:40 Room Grand Ballroom 104 [Breakfast Symposium 11 - Lilly] Improving Outcomes for the Patients with axSpA Exploring the impact of Ixekizumab in treatment for biologics-naive patients with Spondyloarthritis