Update on IL-17 Inhibitors for Psoriasis
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PSORIASIS (J WU, SECTION EDITOR)
Update on IL-17 Inhibitors for Psoriasis Rhea Singh 1 & Esther A. Balogh 1 & Steven R. Feldman 1,2,3,4 Accepted: 27 October 2020 / Published online: 11 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Psoriasis is a common chronic, inflammatory skin condition. The pathogenesis of psoriasis involves many cytokines in the IL-17 family and their subsequent signaling cascade; therefore, IL-17 inhibitors may have utility in the treatment of psoriasis. This review aims to evaluate the efficacy and safety of IL-17 inhibitors and their emerging role as a therapeutic option for patients with psoriasis. Recent Findings In multiple phase III clinical trials, IL-17 inhibitors were more efficacious than placebo or slightly more efficacious in comparisons to many other systemic and biologic treatments. Overall, IL-17 inhibitors have a fairly mild side effect profile for use in psoriasis. One of the more severe theoretical adverse events is the activation or reactivation of inflammatory bowel disease. Many long-term ongoing clinical trials have promising initial results. Summary Data suggests IL-17 inhibitors are efficacious and safe for use in patients with psoriasis. Patient non-adherence to taking daily pills or failed therapy with older systemic agents may be indications for the use of IL-17 inhibitors in patients with psoriasis. Keywords IL-17 inhibitor . PASI . Psoriasis
Introduction Psoriasis is a chronic immune-mediated, inflammatory skin disease that presents as well defined, erythematous plaques covered in silver scales. The most common disease sites are the extensor surfaces, trunk, and scalp; the lesions are often pruritic [1]. Psoriasis affects 100 million people worldwide and has a prevalence of between 1.5% and 5% in developed countries around the world [2]. It follows a bimodal age disThis article is part of the Topical Collection on Psoriasis * Rhea Singh [email protected] 1
Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
2
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
3
Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
4
Department of Dermatology, University of Southern Denmark, Odense, Denmark
tribution with peaks of incidence at 30 to 39 and 60 to 69 years of age and affects males and females almost equally in most populations [2, 3]. There are over 70 susceptible loci that have an established link with psoriasis [4]. The most susceptible locus, PSORS1, is located on chromosome 6p21, which has a strong link in patients with psoriasis. In this region, there were nine genes identified, three of which have a strong association to psoriasis (HLA-Cw6, CCHCR1, and CDSN) [5–7]. Both children and adults with psoriasis may have psychosocial morbidities and impairment in their quality of life; similarly, decreases in quality of life m
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