Efficacy and Safety of Xeligekimab Compared to Other IL-17A Inhibitors for Chinese Patients with Moderate-to-severe Plaque Psoriasis: A Matching-adjusted Indirect Comparisons.

Direct comparative evidence between IL-17A inhibitors for plaque psoriasis in Chinese populations remains limited. This study evaluated the comparative effectiveness of Xeligekimab vs Secukinumab and Ixekizumab through matchingadjusted indirect comparisons (MAICs). Individual patient data from the Xeligekimab trial (N=281) were weighted to match baseline characteristics from Chinese trials of Secukinumab (N=221) and Ixekizumab (N=176/92). Matching variables were determined following NICE and EUnetHTA MAIC guidelines, incorporating prognostic factors identified through multivariate regression. Primary endpoints included PASI 75/90/100 achievement at weeks 12, 52 and 60. At week 12, Secukinumab showed numerically higher PASI 75 (97.7% vs 93.0%, p=0.052) without statistical significance, while other endpoints were comparable (all p>0.05). At week 52, Xeligekimab showed significantly higher PASI 100 achievement (57.8% vs 42.1%, p=0.005) and DLQI 0/1 (68.8% vs 47.5%, p<0.001) vs Secukinumab. At week 60, Xeligekimab maintained significantly higher PASI 75 vs Ixekizumab (92.6% vs 76.1%, p<0.001) with lower infection rates during induction period (7.9% vs 34.7%, p<0.001) and maintenance period (22.4% vs 56.5%, p<0.001). This MAIC provides hypothesis-enerating evidence that Xeligekimab may offer advantages in specific long-term efficacy endpoints and safety outcomes, requiring confirmation in direct randomized controlled trials.