Ixekizumab (Taltz) is a humanized monoclonal antibody that exerts its anti-inflammatory effects by binding to interleukin 17A (IL-17A) thereby inhibiting the anti-inflammatory chemokines and cytokines.

Ixekizumab Uses:

• Ankylosing spondylitis:

  • It is used to treat adult patients with active ankylosing spondylitis.

• Plaque psoriasis:

  • It is indicated in the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy

• Psoriatic arthritis:

  • It is indicated for the treatment of active psoriatic arthritis in adult patients

Read: Biologics for Psoriasis

Ixekizumab (Taltz) Dose in Adults:

Ixekizumab (Taltz) Dose in the treatment of Ankylosing spondylitis:

• Taltz 160 mg subQ once, followed by 80 mg every 4 weeks;
• The dose may be administered as monotherapy or with disease-modifying antirheumatic drugs like sulfasalazine, glucocorticoids, NSAIDs (nonsteroidal anti-inflammatory drugs), and/or analgesics.

Ixekizumab (Taltz) Dose in the treatment of Plaque psoriasis:

• 160 mg subQ once, followed by 80 mg at weeks 2, 4, 6, 8, 10, and 12, and then 80 mg every 4 weeks.

Ixekizumab (Taltz) Dose in the treatment of Psoriatic arthritis:

• 160 mg subQ once, followed by 80 mg every 4 weeks;
• The dose may be administered alone or in combination with conventional DMARDs like methotrexate.

Note:

In patients with psoriatic arthritis and coexisting moderate to severe plaque psoriasis, the dosing regimen used to treat plaque psoriasis should be used.

Ixekizumab (Taltz) use in Children:

The safety and efficacy of the drug in children have not been established.

Ixekizumab Pregnancy Risk Category: C

• Ixekizumab (humanized monoclonal antibody, IgG) is a humanized monoclonal anti-bodies. It can also cross the placental barriers, just like the endogenous immunoglobulins.
• The first trimester, or the period of organogenesis, is the most likely time for placental transfer.
• It is compatible for male patients with psoriasis to use it to father a child.
• However, to avoid fetal exposure, it should be stopped at least nine weeks before any planned pregnancy in a female.

Ixekizumab use during breastfeeding:

• It is unknown if the drug will be excreted into breastmilk.
• Fetal exposure is possible due to the possibility of immunoglobulins entering breastmilk.
• Manufacturers recommend weighing the benefits and risks of drug exposure for the mother against the risks to the infant.

Taltz Dose in Kidney disease:

It has not been studied in patients with kidney disease. The manufacturer has not provided any adjustment in the dose in patients with kidney disease.

Taltz Dose in Liver disease:

It has not been studied in patients with liver disease. The manufacturer has not provided any adjustment in the dose in patients with liver disease.

Common Side Effects of Ixekizumab (Taltz):

• Hematologic & Oncologic:

  • Neutropenia

• Immunologic:

  • Antibody Development

• Infection:

  • Infection

• Local:

  • Injection Site Reaction

• Respiratory:

  • Upper Respiratory Tract Infection

Less Common Side Effects Of Ixekizumab (Taltz):

• Dermatologic:

  • Tinea

• Gastrointestinal:

  • Nausea
  • Crohn's Disease

• Hematologic & Oncologic:

  • Thrombocytopenia

• Infection:

  • Influenza

• Ophthalmic:

  • Conjunctivitis

Rare side effects of Ixekizumab (Taltz):

• Local:

  • Erythema At Injection Site
  • Pain At Injection Site

Contraindication to Ixekizumab Include:

• Anaphylaxis (and other serious allergic reactions) to any drug or component of the formulation.

Warnings/Precautions

• Hypersensitivity reactions

  • It has been linked to severe allergic reactions.
  • Angioedema and urticaria can all be symptoms of allergic reactions. These may need hospitalization.
  • As soon as serious hypersensitivity reactions become apparent, the treatment should be stopped.
  • Anaphylaxis must always be treated appropriately

• Infections

  • The risk of infection may be increased by taking Ixekizumab (Taltz).
  • Clinical trials revealed that most patients had upper respiratory tract infections, oral candidiasis and conjunctivitis.
  • Patients suffering from chronic or recurrent infections must be advised to avoid the drug.
  • Patients with a serious infection must not be treated until it is completely resolved.

• Tuberculosis

  • Before initiating therapy, all patients eligible for Ixekizumab therapy (Taltz), should be tested for tuberculosis.
  • Anti-IL-17 therapy should not be recommended for patients with active tuberculosis.
  • Patients should be closely monitored throughout and after treatment to ensure that there is no evidence of active tuberculosis or latent tuberculosis.
  • Anti-TB treatment may also be recommended for patients with a history or tuberculosis.

• Inflammatory bowel disease

  • Ixekizumab may increase the risk of developing inflammatory bowel disease (Crohn’s or ulcerative colitis) by being administered to patients.
  • It can lead to an exacerbation in patients with IBD.
  • It is important to monitor patients for colitis symptoms and discontinue treatment if they are found.

Ixekizumab: Drug Interaction

Monitoring parameters:

• Monitor for hypersensitivity reactions,
• Signs and symptoms of infection,
• active tuberculosis during and after treatment, and
• signs and symptoms of inflammatory bowel disease

How to administer Ixekizumab (Taltz)?

• It is administered by the subcutaneous route. Before the injection is administered, it is allowed at room temperature for 30 minutes.
• The injection should not be vigorously shaken. The injection is administered into the abdomen, upper arms, or the thighs.
• The injection site should be rotated. Each injection should be administered into a different anatomic location than the previous injection.
• Administration into inflamed, tender, red, bruised, indurated, or area affected by active psoriatic lesions should be avoided.
• The injection should be administered by a healthcare provider or under the guidance and supervision of a physician.
• After proper training in administering a subQ injection, self-administration may be allowed. 

Mechanism of action of Ixekizumab (Taltz):

• Ixekizumab, a monoclonal humanized IgG-4 antibody that blocks Interleukin 17A from its receptors, is a monoclonal antibody. It binds to IL-17A and inhibits Interleukin 17A binding.
• This reduces pro-inflammatory immune responses as well as the release of cytokines, chemokines and other substances that are mediated via IL-17 receptors.

MetabolismIt is converted to small peptides and amino acids by catabolic pathways that are similar to endogenous immuneglobulins. Bioavailability is60% to 81%, and thehalf-life eliminationThe average time to reach the drug is 13 Days It takes 13 days to reach the desired effect.peak serum concentrationIt takes approximately 4 days.

International Brands of Ixekizumab:

• Taltz

Ixekizumab Brands Names in Pakistan:

No Brands Available in Pakistan.