Ixekizumab
| Monoclonal antibody | |
|---|---|
| Type | Whole antibody |
| Source | Humanized |
| Target | IL-17A |
| Clinical data | |
| Trade names | Taltz |
| AHFS/Drugs.com | taltz |
| License data | |
| Routes of administration | Subcutaneous injection |
| ATC code | |
| Legal status | |
| Legal status |
|
| Pharmacokinetic data | |
| Bioavailability | 54–90% |
| Metabolism | Presumably proteolysis |
| Elimination half-life | 13 days |
| Identifiers | |
| CAS Number | |
| DrugBank | |
| ChemSpider |
|
| UNII | |
| KEGG | |
| Chemical and physical data | |
| Formula | C6492H10012N1728O2028S46 |
| Molar mass | 146.2 kg/mol g·mol−1 |
  (what is this?) (verify) | |
Ixekizumab (trade name Taltz; pronounced ix-ee-KIZ-ue-mab[1]) is an injectable drug for the treatment of autoimmune diseases. Chemically, it is a humanized monoclonal antibody.[2] The substance acts by blocking interleukin 17, reducing inflammation.[3]
The drug was developed by Eli Lilly and Co. and is approved for the treatment of plaque psoriasis in Europe and the US.
Medical uses
Ixekizumab is used for the treatment of moderate to severe plaque psoriasis in adults.[3]
In studies, the drug reduced the Psoriasis Area and Severity Index by at least 75% (PASI75) in 82–89% of patients during the first three months of treatment (depending on the dosing scheme), and 40% of patients experienced a complete absence of psoriasis symptoms (PASI100). In the placebo group, PASI75 was reached in 4% of patients, and PASI100 in none; in the group of patients receiving etanercept, an older anti-psoriasis drug, PASI75 was reached in 48%. Until the 60th study week, 11–44% of ixekizumab treated patients relapsed (again, depending on the dosing scheme), as compared to 84% under placebo.[3][4]
In December 2017 the US FDA approved it for active psoriatic arthritis.[5]
Contraindications
The drug is contraindicated for patients with certain infections such as active tuberculosis.[3]
Adverse effects
In studies, ixekizumab increased the rate of infections (27% of ixekizumab treated patients, compared to 23% under placebo), including severe ones (0.6% versus 0.4% under placebo). Other common side effects included injection site pain (13–17% versus 3%), oropharyngeal pain (1%) and nausea (1–2%).[3]
Overdose
Up to fourfold doses have been given in studies without causing serious side effects.[3]
Interactions
No interaction studies have been done. Ixekizumab and interleukin 17 are not known to interact with cytochrome P450 (CYP) liver enzymes. Since inflammation suppresses CYP activity, it is theorized that ixekizumab could neutralize this effect and lower blood plasma concentrations of drugs that are metabolized by CYP enzymes, such as warfarin.[3]
Pharmacology
Mechanism of action
Ixekizumab binds to interleukin 17 (IL-17), a pro-inflammatory cytokine, and blocks its action. Among other things, IL-17 stimulates proliferation and activation of keratinocytes in the skin.[3] This mechanism is similar to that of another anti-psoriasis antibody, brodalumab, which binds to the interleukin-17 receptor.[6]
The antibody has affinity to the homodimer IL-17A and the heterodimer IL-17A/F, but not to other members of the interleukin 17 family.[3]
Pharmacokinetics
After subcutaneous injection, ixekizumab has a bioavailability of 54–90%. Highest blood plasma concentrations are reached after four to seven days after a single dose. With the usual dosing scheme (loading plus a dose every two weeks), steady state concentrations are reached in the eighth week on average.[3]
Like other antibodies, ixekizumab is probably degraded by proteolysis. Its elimination half-life is 13 days.[3]
Chemistry
Ixekizumab is a complete monoclonal antibody of the subclass IgG4, consisting of two light chains and two heavy chains linked by disulfide bridges. Both heavy chains are glycosylated at the asparagine in position 296. In the hinge region, a serine is replaced by a proline to reduce formation of half-antibodies and heterodimers in the manufacturing process. The terminal lysine found in wild-type IgG4 is removed. The antibody is produced in Chinese hamster ovary cells.[2][7]
History
Clinical trials included a Phase II trial of patients with moderate to severe psoriasis,[6] and a Phase III open-label trial.[8] The drug was approved by the FDA on 22 March 2016 for the treatment of plaque psoriasis, under the trade name Taltz,[9] and by the European Medicines Agency on 25 April 2016 under the same trade name.[10]
The drug was launched in the US on 16 April 2016 and has been approved for use in the UK and is expected to launch on 1 July 2016.[11][needs update]
Research
As of 2016[update], ixekizumab is in Phase III clinical trials for the treatment of active psoriatic arthritis.[12]
References
- ^ "12 Difficult-to-Pronounce Drug Names". pharmacytimes.com. Pharmacy Times. 7 February 2018. Retrieved 22 March 2018.
- ^ a b "Statement On A Nonproprietary Name Adopted By The USAN Council: Ixekizumab" (PDF). American Medical Association.
- ^ a b c d e f g h i j k Haberfeld, H, ed. (2015). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag.
- ^ Klement, A (4 June 2016). "Taltz". Österreichische Apothekerzeitung (in German) (14/2016): 12.
- ^ "FDA approves Taltz for psoriatic arthritis in adults
- ^ a b "Neue Antikörper in der Pipeline". Pharmazeutische Zeitung (in German) (12). 2012.
- ^ "Assessment report: Taltz" (PDF). European Medicines Agency. 25 February 2016. p. 7.
- ^ Clinical trial number NCT01624233 for "A Study in Japanese Participants With Moderate-to-Severe Psoriasis" at ClinicalTrials.gov
- ^ "FDA approves new psiorasis drug Taltz". Food and Drug Administration.
- ^ "Taltz – EPAR summary for the public" (PDF). European Medicines Agency. April 2016.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Design, inNottingham Web. "ixekizumab (Taltz) UKMi New Drugs Online Database". www.ukmi.nhs.uk. Retrieved 2016-06-12.
- ^ Mease, P. J.; Van Der Heijde, D; Ritchlin, C. T.; Okada, M; Cuchacovich, R. S.; Shuler, C. L.; Lin, C. Y.; Braun, D. K.; Lee, C. H.; Gladman, D. D.; Spirit-p1 Study, Group (2016). "Ixekizumab, an interleukin-17A specific monoclonal antibody, for the treatment of biologic-naive patients with active psoriatic arthritis: Results from the 24-week randomised, double-blind, placebo-controlled and active (adalimumab)-controlled period of the phase III trial SPIRIT-P1". Annals of the Rheumatic Diseases: annrheumdis-2016-209709. doi:10.1136/annrheumdis-2016-209709. PMC 5264219. PMID 27553214.
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