Head-to-Head Trial Suggests Ixekizumab Superior to Guselkumab in Skin Clearance


A phase 4 head-to-head trial compared ixekizumab (Taltz) with guselkumab (Tremfya) in patients with moderate-to-severe plaque psoriasis.

In its first phase 4 head-to-head study, Eli Lilly’s ixekizumab (Taltz) demonstrated superiority to guselkumab (Tremfya) in achieving skin clearance in patients with moderate-to-severe plaque psoriasis, according to a press release.

Ixekizumab is currently approved for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy, as well as for adults with active psoriatic arthritis. Along with causing serious health issues, the disease can significantly impact patients’ quality of life.

The IXORA-R study compared the 2 treatments using the Psoriasis Area Severity Index (PASI) 100 score as the primary endpoint at 12 weeks. The study included 1027 patients with moderate-to-severe disease. Patients received ixekizumab (160 mg at week 0, followed by 80 mg at weeks 2, 4, 6, 8, 10, and 12, then 80 mg every 4 weeks) or guselkumab (100 mg administered by subcutaneous injection at weeks 0, 4, and every 8 weeks thereafter) for a total of 24 weeks.

At 12 weeks, ixekizumab met the primary endpoint of superiority over guselkumab in the proportion of patients achieving complete skin clearance as measured by PASI 100, according to the primary analysis.

Additionally, ixekizumab showed superiority over guselkumab in the proportion of patients achieving:

  • PASI 75 at week 2
  • PASI 90 at weeks 4 and 8
  • PASI 100 and weeks 4 and 8
  • Static Physician’s Global Assessment 0 at week 12
  • PASI 50 at week 1

“Lilly’s goal is to raise the treatment bar for people living with psoriasis,” Lotus Mallbris, MD, PhD, vice president of immunology development at Lilly, said in a press release. “And research shows that patients want clear skin and rapid improvements. We’re pleased to see that Taltz helped more people achieve 100% skin clearance compared to Tremfya at week 12. These positive results reinforce that Taltz is an important treatment option for people with this disease.”


Lilly Announces Superiority of Taltz (ixekizumab) versus Tremfya (guselkumab) in Delivering Total Skin Clearance at Week 12 in Topline Results from Head-to-Head (IXORA-R) Trial in People Living with Moderate to Severe Plaque Psoriasis [news release]. Eli Lilly. https://investor.lilly.com/news-releases/news-release-details/lilly-announces-superiority-taltzr-ixekizumab-versus-tremfyar. Accessed August 13, 2019.

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