A new long-term data for two third-generation biologics demonstrated their efficacy and safety for the treatment of plaque psoriasis. The UNCOVER-3 trial showed commendable results at 60 weeks for ixekizumab (Eli Lilly & Co). On the other hand, secukinumab (Cosentyx, Novartis) was superior as compared to ustekinumab (Stelara, Johnson & Johnson) at 52 weeks in the CLEAR study. Secukinumab was the first fully human interleukin 17A (IL-17A) inhibitor for treatment of moderate to severe plaque psoriasis that was approved in the United States. It was also recently approved for the treatment of ankylosing spondylitis and psoriatic arthritis in the United States and the European Union. Ixekizumab, which is also IL-17A inhibitor, would receive approval from the US Food and Drug Administration (FDA) for the treatment of psoriasis.

"The development of biologics has gradually been improving in efficacy as well as safety over the last 15 years," said Andrew Blauvelt, MD, president of Oregon Medical Research Center in Portland, "We're in the third generation of biologics, and we're getting better and better and better." He was also the principal investigator for both trials. The results of both studies were presented at 74th Annual Meeting of the American Academy of Dermatology (AAD).

Secukinumab and ixekizumab have more blocking effect on psoriasis-associated inflammation while targeting IL-17 than ustekinumab that targets IL-12 and IL-23. Whereas, all three biologic agents have advantages over infliximab, adalimumab, and etanercept, which are the older tumour necrosis factor alpha inhibitors. These inhibitors are more effective and less prone to result in severe infection, Blauvelt explained. After the findings, it was concluded that patients with ustekinumab would have a slower recurrence of disease than secukinumab as it is given to have longer effect. It is difficult to judge a particular biologic based on which is better as each biologic has its significance according to preferences of patients.

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