Anti-IL17 therapies for psoriasis

ABSTRACT

Introduction: Interleukin-17 (IL-17) is a proinflammatory cytokine considered to play a significant role in the immunopathogenesis of plaque psoriasis. As a result, focus in clinical trials has undergone a shift towards disease specific targets, with the goals of more effective treatment and reduction in the incidence of serious adverse events.

Areas covered: Two monoclonal antibodies targeting IL-17A (secukinumab, ixekizumab) and one against the IL-17 receptor (brodalumab) are approved for the treatment of moderate-to-severe plaque psoriasis. Herein, the clinical efficacy, safety and tolerability of each is reviewed by summarizing the existing literature (found via PubMed database).

Expert commentary: The development and approval of the IL-17 inhibitor agents secukinumab, ixekizumab, and brodalumab has expanded psoriatic treatment with effective options, validating the importance of the pro-inflammatory role of IL-17 psoriatic pathophysiology. Biologic treatment options for psoriasis will continue to grow, especially IL-17 and IL-23 related agents, with an increasing specificity of agents to be available in the future.

KEYWORDS:

• Psoriasis
• biologics
• interleukin-17 inhibitors
• secukinumab
• ixekizumab
• brodalumab

Article highlights

• IL-17 plays a significant role in the immunopathogenesis of psoriasis.

• Currently, secukinumab and ixekizumab are IL-17 inhibitors and brodalumab is an IL-17 receptor antagonist that have been approved for the treatment of moderate-to-severe psoriasis.

• Secukinumab and ixekizumab, two IL-17A agents, have shown high quality early responses and maintenance of clinical improvement in patients, while brodalumab, which blocks the IL-17 receptor, has exhibited rapid early response as well, especially in patients with a significant inflammatory flare of their psoriasis.

• Bimekizumab is currently undergoing phase 3 clinical trials for psoriasis and appears a likely strong future contender in the treatment for psoriasis as its inhibition of both IL-17A and IL-17F has shown rapid improvement, in some patients after only 2 weeks.

• The development and approval of IL-17 agents for psoriasis has expanded the inventory of effective treatment options for patients with moderate-to-severe psoriasis.

This box summarizes key points contained in the article.

Declaration of interest

A Menter reports grants and honoraria from: Abbott Labs, Amgen, Boehringer Ingelheim, Janssen Biotech Inc., LEO Pharma, and Sienna Pharmaceuticals; grants from Celgene and Merck; honoraria from: Eli-Lilly, Novartis, and UCB. A Menter is an investigator, consultant, advisor, and speaker for Abbott Labs, Amgen, Janssen Biotech Inc., LEO pharma, and Sienna pharmaceuticals; advisor and investigator for Boehringer Ingelheim; investigator for Celgene, Merck, AbbVie, Dermira, and Incyte; consultant and investigator for Eli-Lilly and Novartis; consultant, investigator and speaker for UCB. SY Paek is an investigator for Janssen, Novartis, Dermira, Incyte, Sienna and has been a consultant for AbbVie, Celgene, and Janssen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.