COPELLOR

Indications

• Moderate-to-severe plaque psoriasis
• Psoriatic arthritis with concomitant moderate-to-severe plaque psoriasis
• Ankylosing spondylitis
• Non-radiographic axial spondyloarthritis

Dosage

Children: null

Adults: Initially 160 mg as a single dose, followed by 80 mg after 2 weeks. Maintenance dose is 80 mg every 4 weeks. Consider discontinuation if no response after 16–20 weeks.

Mechanism of action

Ixekizumab acts by specifically binding to interleukin-17A, thereby inhibiting its interaction with the IL-17 receptor. This blockade prevents the release of pro-inflammatory cytokines and chemokines, which are critical in mediating inflammatory responses in conditions like psoriasis and psoriatic arthritis.

Pharmacodynamics

The pharmacodynamic effects of ixekizumab are primarily related to its action on IL-17A, leading to decreased inflammation and improvement in skin lesions associated with plaque psoriasis and symptoms of psoriatic arthritis. Clinical studies have demonstrated significant reductions in the severity of psoriatic lesions and improvements in physical function scores in patients treated with ixekizumab.

Pharmacokinetics

Ixekizumab has a half-life of approximately 13 days, allowing for a dosing schedule that can be spaced out after initial treatment. It is administered subcutaneously and achieves peak plasma concentrations within 5 to 6 days post-injection. The drug is primarily eliminated via the reticuloendothelial system, and its pharmacokinetics may be affected by patient-specific factors including body weight and metabolic status.

Contra-indications

• Active infections (including active tuberculosis)
• Clinically significant active systemic therapy
• Inflammatory bowel disease

Adverse effects

• Arthralgia
• Diarrhoea
• Headache
• Increased risk of infection
• Skin reactions

Interactions

• Caution in patients with a history of chronic or recurrent infection
• Consideration of tuberculosis therapy before initiation

Precautions

• Risk of infection
• Monitor for signs and symptoms of active tuberculosis during and after treatment
• Evaluate patients for tuberculosis infection before treatment
• Monitor liver enzymes before starting treatment and as clinically indicated

Pregnancy

Manufacturer advises to avoid use during pregnancy as no information is available.

Breast-feeding

Manufacturer advises to avoid use during breastfeeding and for up to 12 weeks after discontinuing treatment, as no information is available.

Storage

Store in a refrigerator (2–8°C) and protect from light.

Formulations

• 100 mg/1 ml solution for injection pre-filled pens