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Abstract
Background: Studies investigating the molecular basis of psoriasis have established the central roles of TNFα, interleukin (IL)-12, IL-22 and IL-23 and there is increasing evidence that IL-17 plays a critical role in the complex pathophysiology. Preclinical studies suggest that IL-17 is a desirable therapeutic target for psoriasis treatment.
Methods: We reviewed the results of the phase II clinical trials for the anti-IL-17 agents secukinumab, ixekizumab and brodalumab in order to assess the efficacy and safety profile of each agent.
Results: By week 12, the proportion of patients reaching Psoriasis Area and Severity Index (PASI 75) was comparable among the most efficacious dosage between the different agents (secukinumab 82%, ixekizumab 83% and brodalumab 82%; p < 0.001 compared to placebo for all agents). The safety profiles of the agents were similar with the most frequently reported adverse events of nasopharyngitis, upper respiratory infections and injection site reaction. A small percentage of patients experienced low-grade neutropenia that was predominantly transient and asymptomatic.
Conclusion: The anti-IL-17 agents demonstrated a rapid and robust clinical improvement accompanied by a favorable short-term safety profile. The results of the phase II trials support the theory that the IL-17 pathway is an essential target in psoriasis treatment.
Declaration of interest
Dr John Koo is a speaker for AbbVie and Leo. Dr Koo conducts research for Amgen, Janssen, Novartis, Photomedex, Galderma, Pfizer and Merck. Dr Koo has no stocks, employment or board memberships with any pharmaceutical company. None of the grants were directly related to this study.
The other authors (Ms. Gabrielle Brown, Ms. Mona Malakouti, Ms. Eva Wang and Dr Ethan Levin) report no conflicts of interest.