COMPARATIVE EFFICACY OF APPROVED IL-17 INHIBITORS FOR MODERATE-TO-SEVERE PLAQUE PSORIASIS: A SYSTEMATIC LITERATURE REVIEW & BAYESIAN NETWORK META-ANALYSIS
Author(s)
Anwesha Amit Kandhare, MPH1, Sai Krishna Anand Vullendula, PhD2, Priya Ganpathy, MPH3, Shweta S. Pitre, MPH4, Vatsal Shah, MD5.
1Siro Medical Writing Pvt. Ltd, Pune, India, 2Siro Medical Writing Pvt. Ltd, Hyderabad, India, 3Siro Clinpharm UK Limited, London, United Kingdom, 4SIRO Clinpharm UK Limited, London, United Kingdom, 5Siro Clinpharm USA, LLC, Princeton, NJ, USA.
1Siro Medical Writing Pvt. Ltd, Pune, India, 2Siro Medical Writing Pvt. Ltd, Hyderabad, India, 3Siro Clinpharm UK Limited, London, United Kingdom, 4SIRO Clinpharm UK Limited, London, United Kingdom, 5Siro Clinpharm USA, LLC, Princeton, NJ, USA.
OBJECTIVES: Limited comparative data from head-to-head trials exist among the multiple IL-17 inhibitors approved for moderate-to-severe plaque psoriasis. This network meta-analysis (NMA) was designed to compare the efficacy of approved IL-17 inhibitors, secukinumab, ixekizumab, bimekizumab, and brodalumab in adults with moderate-to-severe plaque psoriasis, using psoriasis area-and-severity index (PASI) 75 response.
METHODS: PubMed (MEDLINE), Google Scholar, and ClinicalTrials.gov were searched from database inception to May 2026. Double-blind, randomized controlled trials in adults (≥18 years) with confirmed diagnosis of moderate-to-severe plaque psoriasis receiving IL-17 inhibitors (sample size ≥20) were included. Open-label, extension, retrospective, and non-English studies were excluded. Screening was conducted in duplicate. Risk of bias was assessed using Cochrane RoB2. Random-effects Bayesian NMA was performed in R v4.4.3; primary outcome was PASI 75. Treatment rankings were estimated using Surface Under the Cumulative Ranking Curve (SUCRA) and comparative effects reported as risk ratios (RR) with 95% credible intervals (CrI) versus placebo and active controls.
RESULTS: Of 509 records identified, 17 met inclusion criteria (mean follow-up:12 weeks). For PASI 75, bimekizumab 320 mg Q2W had highest probability of being best-ranked treatment (SUCRA=0.912; RR vs placebo 1.80, 95% CrI 0.47;12.91), followed by ixekizumab Q2W (SUCRA=0.809; RR 1.88, 95% CrI 0.50;13.59), ixekizumab Q4W→Q2W (SUCRA=0.798), brodalumab 210 mg (SUCRA=0.796), bimekizumab 160 mg Q4W (SUCRA=0.731), ixekizumab Q4W (SUCRA=0.713), and bimekizumab 480 mg (SUCRA=0.703). CrI included 1.0 for all active versus placebo comparisons.
CONCLUSIONS: Bimekizumab 320 mg had the highest probability of being the best-ranked IL-17 inhibitor for PASI 75, providing directional evidence to inform treatment decisions. Wide CrI reflects uncertainty inherent to the sparse evidence network and not the absence of treatment effect and preclude definitive conclusions on comparative efficacy between active therapies. Ongoing analyses of PASI 90, PASI 100, and long-term outcomes (48-52 weeks) are expected to further characterise the comparative efficacy profile of IL-17 inhibitors.
METHODS: PubMed (MEDLINE), Google Scholar, and ClinicalTrials.gov were searched from database inception to May 2026. Double-blind, randomized controlled trials in adults (≥18 years) with confirmed diagnosis of moderate-to-severe plaque psoriasis receiving IL-17 inhibitors (sample size ≥20) were included. Open-label, extension, retrospective, and non-English studies were excluded. Screening was conducted in duplicate. Risk of bias was assessed using Cochrane RoB2. Random-effects Bayesian NMA was performed in R v4.4.3; primary outcome was PASI 75. Treatment rankings were estimated using Surface Under the Cumulative Ranking Curve (SUCRA) and comparative effects reported as risk ratios (RR) with 95% credible intervals (CrI) versus placebo and active controls.
RESULTS: Of 509 records identified, 17 met inclusion criteria (mean follow-up:12 weeks). For PASI 75, bimekizumab 320 mg Q2W had highest probability of being best-ranked treatment (SUCRA=0.912; RR vs placebo 1.80, 95% CrI 0.47;12.91), followed by ixekizumab Q2W (SUCRA=0.809; RR 1.88, 95% CrI 0.50;13.59), ixekizumab Q4W→Q2W (SUCRA=0.798), brodalumab 210 mg (SUCRA=0.796), bimekizumab 160 mg Q4W (SUCRA=0.731), ixekizumab Q4W (SUCRA=0.713), and bimekizumab 480 mg (SUCRA=0.703). CrI included 1.0 for all active versus placebo comparisons.
CONCLUSIONS: Bimekizumab 320 mg had the highest probability of being the best-ranked IL-17 inhibitor for PASI 75, providing directional evidence to inform treatment decisions. Wide CrI reflects uncertainty inherent to the sparse evidence network and not the absence of treatment effect and preclude definitive conclusions on comparative efficacy between active therapies. Ongoing analyses of PASI 90, PASI 100, and long-term outcomes (48-52 weeks) are expected to further characterise the comparative efficacy profile of IL-17 inhibitors.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA43
Topic
Clinical Outcomes, Health Technology Assessment, Study Approaches
Topic Subcategory
Meta-Analysis & Indirect Comparisons
Disease
Biologics & Biosimilars, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)