The dark side of the moon: the immune-mediated adverse events of IL-17A/IL-17R inhibition

Abstract

As aberrant IL-17 signaling plays a critical role in the pathogenesis of psoriasis, biologic agents targeting this pathway have become an important weapon against this disease. Some biologic agents such as IL-17 inhibitors (secukinumab and ixekizumab) and the IL-17 receptor (IL17R) inhibitor (brodalumab) are relatively safe, tolerable and efficacious drugs. Nevertheless, side effects of IL-17 pathway inhibition occur. This review focuses on the dermatological manifestations linked to these treatments. Paradoxical psoriasis and atopic-like eczema may be the most common cutaneous adverse events, while manifestations such as neutrophilic dermatoses, hypersensitivity reactions, lichenoid eruptions, vasculitides, bullous diseases, lupus-like reactions, pigmentation disorders, adnexal diseases and granulomatous dermatoses have been described less frequently.

Keywords:

• Biologic therapy
• IL-17
• secukinumab
• ixekizumab
• brodalumab

Author contributions

All authors have made substantial contributions to the design of the work, drafted the work and revised it critically for important intellectual content. All authors approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).