Ixekizumab (Taltz)

Ixekizumab, marketed under the brand name Taltz, is a monoclonal antibody used primarily for the treatment of several inflammatory conditions, including moderate to severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. Developed by Eli Lilly and Company, Taltz is an injectable medication that specifically targets the interleukin-17A (IL-17A) cytokine, which plays a central role in the inflammatory processes underlying these diseases.

How Ixekizumab Works

Mechanism of Action:

1. Targeting IL-17A:
   • Ixekizumab is a humanized monoclonal antibody that binds specifically to interleukin-17A (IL-17A), a pro-inflammatory cytokine. IL-17A is heavily involved in the immune response and is overexpressed in inflammatory conditions like psoriasis and psoriatic arthritis.
2. Blocking Inflammatory Pathways:
   • By binding to IL-17A, ixekizumab prevents this cytokine from interacting with its receptors on various cells in the body. This interaction typically triggers a cascade of immune responses that lead to inflammation and tissue damage.
3. Reduction of Inflammation:
   • The inhibition of IL-17A reduces the activity of the immune system’s inflammatory pathways, which are responsible for the symptoms of conditions like plaque psoriasis and psoriatic arthritis, such as skin lesions, joint pain, and swelling.
4. Improvement in Symptoms:
   • As a result of reduced inflammation, patients experience an improvement in skin clearing, reduced joint pain, and an overall reduction in the severity of their symptoms.
5. Long-Term Immune Modulation:
   • Continuous administration of ixekizumab helps maintain low levels of IL-17A activity, providing long-term control over chronic inflammatory conditions without broadly suppressing the entire immune system.

Combined Effect:

Ixekizumab’s targeted action helps manage symptoms effectively, improving patients’ quality of life without the broader immune suppression seen with some other therapies.

Side Effects

While ixekizumab is effective, it can cause side effects, ranging from mild to severe. The frequency and severity of side effects can vary among individuals.

Common Side Effects:

• Injection Site Reactions: Redness, swelling, pain, or itching at the injection site.
• Upper Respiratory Tract Infections: Common colds, sore throat, and cough.
• Nausea
• Fungal Infections: Such as athlete’s foot or yeast infections.
• Headache
• Back Pain

Rare but Serious Side Effects:

• Serious Allergic Reactions: Including angioedema and anaphylaxis.
• Serious Infections: Such as tuberculosis or other opportunistic infections.
• Inflammatory Bowel Disease: New or worsening symptoms of Crohn’s disease or ulcerative colitis.

Indications

Ixekizumab is approved for several inflammatory conditions, particularly those that involve overactivity of the immune system.

Approved Indications:

• Moderate to Severe Plaque Psoriasis: For adults and children (6 years and older) who are candidates for systemic therapy or phototherapy.
• Psoriatic Arthritis: Alone or in combination with methotrexate to reduce joint pain, swelling, and improve physical function.
• Ankylosing Spondylitis (Radiographic Axial Spondyloarthritis): To reduce inflammation of the spine, improve pain, and enhance mobility.
• Non-Radiographic Axial Spondyloarthritis: For patients with objective signs of inflammation who have not responded adequately to conventional therapy.

Contraindications

Ixekizumab is generally well-tolerated, but it may not be suitable for everyone. Certain conditions and patient populations should avoid using this medication.

Contraindications:

• Hypersensitivity: Known hypersensitivity to ixekizumab or any of its excipients.
• Active Infections: Including tuberculosis or other severe infections, where starting a new immunosuppressant could worsen the infection.
• Patients with Crohn’s Disease: Due to potential exacerbation of symptoms or disease.
• Pregnancy and Breastfeeding: Insufficient data on safety; should only be used if the benefits outweigh the risks.
• History of Severe Allergic Reactions to Biologics: High risk of severe hypersensitivity or anaphylactic reaction.

Price in Different Countries

The price of ixekizumab varies across countries, depending on healthcare policies, insurance coverage, and distribution costs. Below is a table showing the approximate prices in various countries.

Country	Price per injection (80 mg)	Reference
USA	$5,000	Drugs.com
UK	£1,000	BNF
Australia	$2,500	PBS
Canada	$4,000	DrugBank
UAE	$4,500	Medicines.org.ae

Top 5 Global Brands

Ixekizumab and other biologics targeting IL-17 are produced by various leading pharmaceutical companies globally. Here are the top brands in this category:

1. Eli Lilly and Company – Taltz (Ixekizumab)

• Eli Lilly, a major global pharmaceutical company, is the developer of Taltz, which targets IL-17A to manage inflammatory conditions.

2. Novartis – Cosentyx (Secukinumab)

• Another IL-17A inhibitor, Cosentyx is widely used for similar indications, including psoriasis and psoriatic arthritis.

3. Amgen – Enbrel (Etanercept)

• While not an IL-17A inhibitor, Enbrel is a leading biologic for similar conditions, working as a TNF inhibitor.

4. AbbVie – Skyrizi (Risankizumab)

• Targets IL-23, another key cytokine involved in psoriasis and psoriatic arthritis, with a different but related mechanism of action.

5. Johnson & Johnson (Janssen Pharmaceuticals) – Stelara (Ustekinumab)

• Stelara inhibits IL-12 and IL-23, offering broad control over multiple inflammatory pathways related to psoriasis.