Objective:

To evaluate the effectiveness and safety of switching to ixekizumab, guselkumab, or ustekinumab in patients with moderate-to-severe plaque psoriasis who failed secukinumab.

Approach:

• Study Design: Retrospective cohort study analyzing 59 patients who switched from secukinumab to ixekizumab, guselkumab, or ustekinumab.
• Endpoints: Primary endpoints included PASI 75, PASI 90, and PASI 100 response rates at weeks 12, 24, and 52.
• Data Handling: Missing data were managed using non-responder imputation (NRI).

Key Findings:

• Ixekizumab had a higher PASI 75 response rate at week 12 compared to guselkumab and ustekinumab (66.7% vs. 28.1% vs. 16.7%, P = 0.010).
• In the secondary failure subgroup, ixekizumab showed a numerical advantage in PASI 75 response at all time points but did not reach statistical significance.
• Adverse event rates were 28.6% for ixekizumab, 12.5% for guselkumab, and 33.3% for ustekinumab, with no significant differences between groups (P = 0.281).

Interpretation:

Limitations:

• Small sample size may limit the generalizability of findings.
• Limited statistical power for subgroup analyses due to sample size.

Conclusion: