Anti-IL-17 Agents in the Treatment of Axial Spondyloarthritis

Abstract

Axial spondyloarthritis (axSpA) describes a group of chronic inflammatory rheumatic diseases primarily involving the axial skeleton. IL-17 is involved in the pathogenesis of numerous inflammatory diseases, including inflammatory arthritis. Until a few years ago, the only biological agents licensed for the treatment of axSpA and nr-axSpA were TNF inhibitors. However, as some patients did not respond to TNF inhibition or experienced secondary failure, the introduction of the first two IL-17 inhibitors (secukinumab [SEC] and ixekizumab [IXE]) has extended the treatment options, and there are now three others (bimekizumab, brodalumab and netakimab) in various stages of clinical development. The last ten years have seen the development of a number of therapeutic recommendations that aimed at improving the management of axSpA patients. The aim of this narrative review of the published literature concerning the role of IL-17 in the pathogenesis of SpA, and the role of IL-17 inhibitors in the treatment of axSpA, is to provide a comprehensive picture of the clinical efficacy and safety of the drugs themselves, and the treatment strategies recommended in the international guidelines.

Keywords:

• spondyloarthritis
• ankylosing spondylitis
• non radiographic axial spondyloarthritis
• axial spondyloarthritis
• anti-TNF drugs
• anti-IL17 drugs
• interleukin 17

Disclosure

Dr Salvatore D’Angelo reports personal fees from Abbvie, Eli Lilly, Novartis, and UCB, outside the submitted work. The authors reported no other potential conflicts of interest for this work.