title: Effect of Ixekizumab Treatment on Work Productivity for Patients With Moderate-to-Severe Plaque Psoriasis: Analysis of Results From 3 Randomized Phase 3 Clinical Trials.
abstract: Therapies that reduce psoriasis symptoms may improve work productivity.
  
  
  
  To assess the effect of ixekizumab therapy on work productivity, measured by the Work Productivity and Activity Impairment-Psoriasis (WPAI-PSO).
  
  
  
  Three multicenter, randomized double-blind phase 3 trials conducted during the following periods: December 2011 through August 2014 (UNCOVER-1), May 2012 through April 2015 (UNCOVER-2), and August 2012 through July 2014 (UNCOVER-3). Adult outpatients with moderate-to-severe chronic plaque psoriasis were included.
  
  
  
  In UNCOVER-1, patients were randomized 1:1:1 to subcutaneous placebo or 80 mg ixekizumab every 2 weeks (Q2W) or every 4 weeks (Q4W) for 12 weeks; UNCOVER-2 and UNCOVER-3 also had an etanercept arm (50 mg twice weekly). Maintenance of initial ixekizumab response was evaluated in UNCOVER-1 and UNCOVER-2 during a randomized withdrawal period following week 12 through week 60. The WPAI-PSO questionnaire was administered at baseline and week 12 for all patients and at weeks 24, 36, 52, and 60 for patients in UNCOVER-1 and UNCOVER-2.
  
  
  
  Change in work productivity from baseline as measured by WPAI-PSO scores.
  
  
  
  Across trials, 5101 patients consented; 3866 were randomized (mean [SD] age, UNCOVER-1, 45.7 [12.9] y, 68.1% male; UNCOVER-2: 45.0 [13.0] y, 67.1% male; UNCOVER-3: 45.8 [13.1] y, 68.2% male). At week 12 in UNCOVER-1, the ixekizumab Q4W and ixekizumab Q2W groups showed significantly greater improvements in WPAI-PSO scores (least squares mean change from baseline [SE]) relative to placebo: absenteeism (-3.5 [0.87], P < .001; -2.6 [0.84], P = .003, respectively, vs 0.2 [0.88]), presenteeism (-18.8 [1.28], P < .001; -18.3 [1.24], P < .001, vs 0.5 [1.30]), work productivity loss (-20.6 [1.38], P < .001; -19.8 [1.33], P < .001, vs -0.8 [1.40]), and activity impairment (-24.5 [1.18], P < .001; -25.2 [1.15], P < .001, vs 0.8 [1.18]). Similar results were obtained for UNCOVER-2 and UNCOVER-3, with the exception of absenteeism with ixekizumab Q4W in UNCOVER-2. Additionally, ixekizumab-treated patients showed significantly greater improvements in WPAI-PSO scores vs etanercept-treated patients: UNCOVER-2: presenteeism, work productivity loss, activity impairment (P < .001 both doses), UNCOVER-3: activity impairment (ie, regular activities outside of work) (ixekizumab Q2W; P = .009). Improvements in WPAI-PSO scores at week 12 were sustained to at least week 60.
  
  
  
  Ixekizumab-treated patients reported short- and long-term improvements in work productivity, which could lead to reduced productivity-related cost burden in patients with psoriasis.
  
  
  
  clinicaltrials.gov Identifiers: NCT01474512, NCT01597245, NCT01646177.
authors.affiliation: Keck School of Medicine at USC, University of Southern California, Los Angeles.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Lynde
authors.affiliation: Royal Free London NHS Foundation Trust, London, England.
authors.forename: Sandy R
authors.initials: SR
authors.lastname: McBride
authors.affiliation: Dermatology Unit B2:01, Karolinska University Hospital, Solna, Stockholm, Sweden.
authors.forename: Mona
authors.initials: M
authors.lastname: Ståhle
authors.affiliation: Eli Lilly and Company, Indianapolis, Indiana.
authors.forename: Emily
authors.initials: E
authors.lastname: Edson-Heredia
authors.affiliation: Eli Lilly and Company, Indianapolis, Indiana.
authors.forename: Baojin
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Eli Lilly and Company, Indianapolis, Indiana.
authors.forename: David
authors.initials: D
authors.lastname: Amato
authors.affiliation: Eli Lilly Benelux, Brussels, Belgium.
authors.forename: Enkeleida
authors.initials: E
authors.lastname: Nikaï
authors.affiliation: Eli Lilly and Company, Indianapolis, Indiana.
authors.forename: Fan Emily
authors.initials: FE
authors.lastname: Yang
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Gordon
mesh_terms: D000041:Absenteeism; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004526:Efficiency; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069597:Presenteeism / Q000706:statistics & numerical data; D011565:Psoriasis / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; C549079:ixekizumab; D000068800:Etanercept