General
Recommendations for Biologic Therapies
The
information provided is for reference only and does not constitute a
treatment recommendation. Health care decisions to prescribe
ixekizumab should be based on the best clinical judgment of the
prescribing healthcare practitioner.
In
general, psoriasis treatment guidelines from the British Association
of Dermatologists recommend stopping biologic therapy for at least
four half-lives prior to major elective surgical procedures, and
restarting biologic treatments postoperatively, provided that wound
healing is satisfactory and there is no evidence of infection.1,2
In
general, the American College of Rheumatology and American
Association of Hip and Knee Surgeons recommend stopping biologic
medications prior to surgery and scheduling surgery at the end of the
dosing cycle. It is also recommended to resume medications at minimum
14 days after surgery in the absence of wound healing problems,
surgical site infection, or systemic infection.3
Ixekizumab
Label Information
The
mean elimination half-life is 13 days in patients with plaque
psoriasis, psoriatic arthritis, radiographic axial spondyloarthritis
and non-radiographic axial spondyloarthritis.4
Treatment
with ixekizumab is associated with an increased rate of infections
such as upper respiratory tract infection, oral candidiasis,
conjunctivitis, and tinea infections.4
Ixekizumab
should be used with caution in patients with clinically important
chronic infection or a history of recurrent infection. Patients
should be instructed to seek medical advice if signs or symptoms
suggestive of an infection occur. If an infection develops, monitor
carefully and discontinue ixekizumab if the patient is not responding
to standard therapy or the infection becomes serious. Ixekizumab
should not be resumed until the infection resolves.4
References
1.
Smith CH, Anstey AV, Barker JN, et al. British Association of
Dermatologists’ guidelines for biologic interventions for
psoriasis 2009. Br J Dermatol. 2009;161(5):987-1019.
http://dx.doi.org/10.1111/j.1365-2133.2009.09505.x
2.
Bakkour W, Purssell H, Chinoy H, et al. The risk of post-operative
complications in psoriasis and psoriatic arthritis patients on
biologic therapy undergoing surgical procedures. J Eur Acad
Dermatol Venereol. 2016;30(1):86-91.
http://dx.doi.org/10.1111/jdv.12997
3.
Goodman SM, Springer B, Guyatt G, et al. 2017 American College of
Rheumatology/American Association of Hip and Knee Surgeons guideline
for the perioperative management of antirheumatic medication in
patients with rheumatic diseases undergoing elective total hip or
total knee arthroplasty. Arthritis Care Res (Hoboken).
2017;69(8):1111-1124. http://dx.doi.org/10.1002/acr.23274
4.
Taltz [summary of product characteristics]. Eli Lilly Nederland
B.V., The Netherlands.
Glossary
axSpA
= axial spondyloarthritis
PsA
= psoriatic arthritis