Can IL-17 and IL-12/23 Help When TNFi Can’t?

Patients with psoriasis (PsO) and psoriatic arthritis (PsA) who did not respond to tumor necrosis factor inhibitors (TNFi) often did show response to interleukin (IL)-17 and IL-12/23 inhibitors, a new systematic review revealed. The findings of the study were published in the Clinical and Experimental Dermatology.

“TNFi were the first biologics approved for the treatment of PsO and PsA. However, some patients are intolerant of or unresponsive to TNFi,” the authors explained. The researchers conducted the systematic review “to investigate the therapeutic effect of IL-17 and IL-12/23 inhibitors,” especially among patients who were intolerant of or had responded inadequately to TNFi therapy.

They collected information on 3,398 patients with PsA from 7 studies searched from the PubMed, Cochrane Library, and Embase databases. Outcomes included:

• Psoriasis Area and Severity Index 75 and 90;
• American College of Rheumatology response criteria (ACR20, ACR50, ACR70)
• complete resolution of dactylitis/enthesitis.

The final study comprised 1330 patients who had not responded to or tolerated TNFi therapy.

The ACR responses were significantly different between TNFi-experienced and TNFi-naïve patients only for IL-12/23 inhibitors. “Significantly more TNFi-experienced patients achieved ACR20 response compared with patients receiving placebo, and the differences in treatment efficacy between TNFi-experienced and TFNi-naïve patients was not significant,” the authors elaborated.

—Priyam Vora

Reference:
Xie Y, Liu Y. Does previous use of tumour necrosis inhibitors change the therapeutic effect of interleukin (IL)-17 or IL-12/23 inhibitors on psoriasis and psoriatic arthritis? Results of a systematic review. Clin Exp Dermatol. 2022; 47: 1627-1635. DOI: https://doi.org/10.1111/ced.15237