Expansion of Taltz Coverage to First-Line Biologic Treatment for Ankylosing Spondylitis: A Game-Changer for Patients

[의학신문·일간보사=김상일 기자] Taltz, Lilly Korea’s interleukin 17A inhibitor (ingredient name: ixekizumab), was added to health insurance coverage for patients with active and progressive psoriatic arthritis and severe ankylosing spondylitis refractory to TNF inhibitors, respectively in July 2019 and in October 2020, in August 2021 the criteria were extended to first-line biologic treatment for patients with psoriatic arthritis.

Taltz’s challenge didn’t stop there. Additionally, in December 2023, the sixth anniversary of the first approval, we were able to expand the reimbursement criteria to a first-line biologic treatment for patients with severe ankylosing spondylitis, further broadening the treatment base for patients.

Ankylosing spondylitis is a chronic spinal arthropathy in which the spinal nodes gradually harden due to inflammation of the spine. It is not a musculoskeletal disease limited to the spine or joints, but a systemic disease that can affect all organs of the body.

Prior to this coverage expansion, Taltz coverage applied only to adult patients with active ankylosing spondylitis who did not respond to one or more TNF inhibitors or who discontinued treatment due to side effects or contraindications.

However, 30-40% of patients using TNF inhibitors did not achieve adequate disease control or symptom relief, and because prescribing TNF inhibitors was contraindicated for patients with heart failure, serious infections, or tuberculosis, Effective first-line biologic agents were needed. for these patients.

Fortunately, as of December 1 of last year, the reimbursement standard for interleukin 17A inhibitors, including Taltz, was changed to “severely active patients who have had insufficient effect or discontinued treatment due to effects side effects despite treatment with two or more non-steroidal painkillers”. -inflammatory or antirheumatic drugs for more than 3 months Has been expanded to include “patients with ankylosing spondylitis”.

As a result, Taltz has emerged as a first-line biologic agent that can be used at the same level as TNF inhibitors in the context of treating severe active ankylosing spondylitis.

In particular, the advantage of Taltz is that it can be used early in patients for whom TNF inhibitors are contraindicated and, in this case, slows down radiological progression such as spinal stiffness.

Additionally, when Taltz was used as a second-line biologic treatment for ankylosing spondylitis patients, 80 mg was injected twice at week 0 and then 80 mg once every four weeks, as the standard for reimbursement was expanded a first-line biological treatment. From the beginning, the drug can be administered only once every four weeks, making it easier to manage the treatment program.

Professor Kim Tae-hwan from the Department of Rheumatology at Hanyang University Hospital said: “Taltz can be considered first for patients with severe skin symptoms, high disease activity or ankylosing spondylitis patients who need rapid pain relief”. The company recommended that Taltz be used first in patients with ankylosing spondylitis accompanied by psoriasis. “We preferentially recommend interleukin 17 inhibitors over TNF-α inhibitors,” he explained.

Furthermore, Professor Kim Tae-hwan suggested: “As the market is experiencing major changes in Korea due to the expansion of coverage of interleukin 17A inhibitors, including Taltz, both patients and medical personnel should strive for a diagnosis early and active treatment of ankylosing spondylitis”. .”

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