ixekizumab

Action and Spectrum

Actions and spectrum: 

ixekizumab is a monoclonal antibody that acts as an interleukin-17A (IL-17A) antagonist. It specifically targets and blocks the activity of IL-17A, a pro-inflammatory cytokine that plays a key role in the pathogenesis of autoimmune diseases, particularly psoriasis and psoriatic arthritis.

By inhibiting IL-17A, ixekizumab reduces inflammation and helps alleviate the symptoms associated with these conditions, such as skin plaques and joint pain. The treatment of moderate and severe psoriasis and active psoriatic arthritis in adults. 

Drug Interaction

Adverse Reaction

Frequency defined 

1-10% 

Nausea (2%) 

Thrombocytopenia, Grade 1 (3%) 

Tinea infections (2%)  

>10% 

URTI (14%) 

reactions at Injection site (17%)  

<1% 

Serious infections 

Rhinitis 

Urticaria 

Conjunctivitis 

Angioedema 

Serious hypersensitivity reactions 

Neutropenia 

Oral candidiasis 

Influenza 

Inflammatory bowel disease  

Post marketing Reports 

Immune system: Anaphylaxis 

Black Box Warning

Black Box Warning: 

ixekizumab does not have any black box warnings. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: ixekizumab should not be used in individuals with known hypersensitivity or allergy to ixekizumab or any of its components. 
• Active Infections: ixekizumab should not be used in patients with active severe infections, as it may worsen the infection. 
• Immunizations: Live vaccines should not be administered to receive ixekizumab, and it is recommended to complete any necessary immunizations before starting treatment. 

Caution: 

• Infections: ixekizumab may increase the risk of infections, including serious and potentially life-threatening ones. The drug should be used with caution in individuals with a history of chronic or recurrent infections. 
• Tuberculosis (TB): Prior to starting ixekizumab, patients should be screened for latent tuberculosis infection. If latent TB is detected, appropriate treatment should be initiated before starting ixekizumab. 
• Immunizations: Live vaccines should be avoided during ixekizumab treatment, as it may interfere with the immune response to vaccines. 
• Hepatitis B Reactivation: ixekizumab may cause hepatitis B virus reactivation in patients with chronic hepatitis B.  
• Pregnancy and Breastfeeding: The safety of ixekizumab during pregnancy and breastfeeding has not been established.  
• Pediatric Use: The safety and efficacy of ixekizumab in pediatric patients have not been established. 
• Hepatic and Renal Impairment: Use caution in patients with severe hepatic or renal impairment, as there is limited data available in these populations.

Comorbidities: 

• Psoriatic Arthritis: Psoriasis can be associated with psoriatic arthritis, a condition that causes joint pain, stiffness, and swelling. 
• Cardiovascular Disease: Psoriasis has been linked to an increased risk of cardiovascular diseases like heart disease and stroke. 
• Metabolic Syndrome: Some studies suggest that psoriasis may be associated with metabolic syndrome, which includes obesity, high blood sugar, and abnormal cholesterol levels. 
• Depression and Anxiety: Psoriasis can have a significant impact on a person’s emotional well-being, leading to an increased risk of depression and anxiety. 
• Inflammatory Bowel Disease (IBD): Some individuals with psoriasis may also have inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. 
• Obesity: Obesity is more common among people with psoriasis, and it may exacerbate the condition. 
• Non-Alcoholic Fatty Liver Disease (NAFLD): Psoriasis may be associated with an increased risk of NAFLD. 

Pregnancy / Lactation

Pregnancy consideration: US FDA pregnancy category: Not assigned 

Lactation: Excreted into human milk: Unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

ixekizumab is a biologic medication classified as a monoclonal antibody. It specifically targets and inhibits the action of a pro-inflammatory cytokine called interleukin-17A (IL-17A). This cytokine plays an important role in the inflammatory processes associated with various autoimmune conditions, including psoriasis. 

By blocking the action of IL-17A, ixekizumab helps regulate the immune response, reducing inflammation and slowing down the overactive immune system responsible for the symptoms of psoriasis. This leads to a decrease in the production of pro-inflammatory molecules and helps improve the signs and symptoms of psoriasis, such as red, scaly skin patches, itching, and pain.  

Pharmacodynamics: 

• ixekizumab exerts its pharmacodynamic effects by selectively targeting and neutralizing the pro-inflammatory cytokine interleukin-17A (IL-17A). IL-17A plays a significant role in promoting inflammation in various autoimmune diseases, including psoriasis. By binding to IL-17A and inhibiting its activity, ixekizumab reduces the production of pro-inflammatory molecules, such as tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 (IL-1). 
• This inhibition of IL-17A signalling helps regulate the immune response, leading to a reduction in skin inflammation and an improvement in the symptoms of psoriasis. By interfering with the IL-17A pathway, ixekizumab helps restore the balance of the immune system and decreases the abnormal proliferation of skin cells, which is a characteristic feature of psoriasis. 
• The pharmacodynamics of ixekizumab result in a substantial reduction in the severity of psoriasis, leading to clearer skin and improved quality of life for patients with moderate to severe plaque psoriasis. It is important to note that the exact mechanism of action of ixekizumab in other diseases where IL-17A is involved may vary, as its therapeutic effects are specific to the targeted cytokine and its related pathways. 

Pharmacokinetics: 

Absorption 

ixekizumab is administered as a subcutaneous injection, and it is absorbed into the bloodstream from the injection site. 

Distribution 

Once absorbed, ixekizumab is distributed throughout the body to target tissues, including the skin, where it exerts its pharmacological effects. 

Metabolism 

As a monoclonal antibody, ixekizumab undergoes metabolic degradation in the body, primarily through proteolytic breakdown. 

Elimination and excretion 

The elimination of ixekizumab from the body occurs through several routes, including renal excretion and catabolism into smaller fragments that are eventually cleared from the body. 

Adminstartion

Administration: 

ixekizumab is administered as a subcutaneous injection, it is injected just under the skin. The administration of ixekizumab is typically done by a healthcare professional, but some patients may receive training to self-administer the injections at home. The specific dosing schedule and injection site may vary based on the condition being treated. 

For the treatment of plaque psoriasis, the recommended dose of ixekizumab is usually an initial loading dose followed by maintenance doses. The loading dose is often given as two injections of 160 mg each, followed by one injection every 4 weeks (80 mg) as a maintenance dose. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: ixekizumab 

Pronounced: (eye-ZEK-ih-zoo-mab)  

Why do we use ixekizumab? 

ixekizumab is a medication used for the treatment of certain inflammatory conditions. Its primary use is in the management of moderate and severe plaque psoriasis in patients for systemic therapy or phototherapy. Plaque psoriasis is a chronic skin condition characterized by thick, red, and scaly patches on the skin. 

ixekizumab works by targeting and inhibiting specific proteins in the immune system involved in the inflammatory process, thereby reducing the signs and symptoms of psoriasis, and promoting skin healing.