Multidimensional efficacy characterization of xeligekimab in moderate-to-severe plaque psoriasis: regional responses, treatment targets, and patient-reported outcomes from a randomized controlled trial

Background Xeligekimab, a monoclonal antibody targeting interleukin-17A ( IL-17A ), has demonstrated high efficacy in treating moderate-to-severe plaque psoriasis. However, the detailed response patterns across anatomical regions, treatment targets, and patient-reported outcomes remain incompletely elucidated. Methods This post hoc analysis of a phase 3, randomized, double-blind, placebo-controlled trial (CHICTR2100043223) included 420 Chinese patients randomized 2:1 to receive subcutaneous xeligekimab 200 mg every 2 weeks or placebo for 12 weeks, followed by open-label xeligekimab through week 52. Regional Psoriasis Area and Severity Index (PASI) responses across four anatomical sites, treatment targets [ideal target: PASI 90 or absolute PASI ≤3 or body surface area (BSA) ≤1% or Physician’s Global Assessment (PGA) 0/1; acceptable target: PASI 75 or absolute PASI ≤5 or BSA ≤3% or PGA 0/1/2; sustained remission: BSA = 0% or PGA = 0 for ≥6 months], and Dermatology Life Quality Index (DLQI) domain-specific improvements were comprehensively analyzed. Results Xeligekimab produced rapid improvements across all PASI dimensions by week 4, with induration (−60.1%), scaling (−61.9%), and erythema (−50.3%) versus −5.3% to −7.7% for placebo (all P P P   Conclusion Xeligekimab provides rapid symptom resolution across all clinical dimensions, high and sustained achievement of treatment targets, and comprehensive restoration of quality of life. Clinical Trial Registration https://www.chictr.org.cn , identifier CHICTR2100043223.