IL-17 inhibitors and IL-23 inhibitors in psoriasis

IL-17 inhibitors and IL-23 inhibitors in psoriasis


The emerging therapies in psoriasis have been
undergoing tremendous changes in the last 5 to 10 years, and the pace of change seems
to be accelerating. TNF antagonists ushered in the new era of
effective therapies after T-cell agents really were not shown to have much promise; and the
story really since then has been the increasing recognition of the, initially IL-12/-23, and
now IL-23/Th17 pathway. And it’s interesting how the science has
evolved from the clinic in that we believed that IL-12/-23 was important, and now it’s
clear that you really only need to go down the IL-23/Th17 pathway to get these effects. And what we’re seeing from the IL-17 class
of molecules—now we have secukinumab, we have ixekizumab, and brodalumab may show the
sign of light again—these drugs are hitting PASI 75 rapidly, in a robust fashion, hitting
upwards of 80–90%; sustained effect that’s being seen out to a year now reported with
secukinumab and ixekizumab; and really very reassuring safety data to date. We do see some specific impact on candidiasis,
some neutropenia (seen in only a few patients at grade 3/grade 4), which tends to be transient. So, I think that taken together, these are
really exciting drugs that are going to offer us a wonderful option for our patients. And coming right behind them are the IL-23s—guselkumab, and we now have risankizumab —and these two drugs are also showing high effectiveness and offer an advantage in that the frequency of dosing may be less. So, every 3 months, for example, with risankizumab. So I think that it is a really great time
to be doing research and a wonderful time for clinicians treating patients.

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