Is there an increased risk of thrombotic events with Taltz (ixekizumab)?

Taltz (Ixekizumab) and Blood Clots: Risk Assessment

Based on the most recent and highest quality evidence, there is no significant increased risk of thrombotic events associated with Taltz (ixekizumab) treatment. 1

Evidence on Taltz and Thrombotic Risk

The most recent and comprehensive data comes from a 2025 integrated safety analysis of 25 randomized clinical trials that specifically evaluated cerebro-cardiovascular events in patients receiving ixekizumab for psoriasis, psoriatic arthritis, and axial spondyloarthritis:

• The incidence of deep vein thrombosis (DVT) was very low at 0.1 per 100 patient-years across all indications 1
• Pulmonary embolism (PE) rates were similarly low at 0.1 per 100 patient-years in psoriasis and 0.0 per 100 patient-years in psoriatic arthritis and axial spondyloarthritis 1
• Major adverse cerebro-cardiovascular events (MACE) remained low and stable over treatment periods 1

This data is particularly valuable as it represents long-term safety with median exposure of 1.3-2.7 years across different patient populations.

Comparison with Other Biologics and Medications

When considering thrombotic risk with biologics, it's important to note that:

• Certain classes of medications used in inflammatory conditions do carry increased thrombotic risk, particularly:

  • Antiangiogenic agents like bevacizumab (33% increased risk of VTE) 2
  • Thalidomide and lenalidomide (risk of 8-27% when combined with other agents) 2
  • Erythropoiesis-stimulating agents (ESAs) which increase thromboembolism risk by 50-75% 2

• However, interleukin-17A inhibitors like ixekizumab have not demonstrated this risk profile

Long-term Safety Data

A 4-year open-label extension study of ixekizumab reported only one patient with major cardiovascular events over the extended treatment period, further supporting its favorable cardiovascular safety profile 3.

Risk Factors to Consider

While Taltz itself doesn't appear to increase thrombotic risk, certain patient factors may warrant additional monitoring:

• Pre-existing cardiovascular disease
• Traditional cardiovascular risk factors (hypertension, diabetes, hyperlipidemia)
• History of prior thrombotic events
• Immobility
• Concurrent use of medications that increase thrombotic risk

Clinical Implications

1. Routine thromboprophylaxis is not indicated specifically for patients receiving ixekizumab based on current evidence

2. Standard assessment of thrombotic risk factors should be performed prior to initiating therapy:

   • Prior history of VTE
   • Immobility
   • Obesity (BMI ≥35 kg/m²)
   • Concurrent high-risk medications
   • Elevated platelet count (≥350,000/mm³)
   • Elevated leukocyte count (>11,000/mm³)

3. Patients with multiple risk factors for thrombosis may benefit from additional monitoring, but this is based on their underlying risk profile rather than ixekizumab use specifically

Conclusion

The current body of evidence indicates that Taltz (ixekizumab) does not significantly increase the risk of thrombotic events when used for its approved indications. This favorable safety profile has been demonstrated across multiple clinical trials with extended follow-up periods.