Interleukin inhibitors, especially those targeting IL-17 and IL-23, show promise as alternatives in treating psoriatic arthritis. These slides summarize their actions and their clinical potential, with hyperlinks to the relevant publications in the captions.
TH17 cells respond to infections and fungi, releasing a range of cytokines including interleukins that trigger inflammation.
The TH17 pathway is key in the pathogenesis of psoriatic arthritis and related spondyloarthropathies. Levels of these cells correlate with disease activity.
Six agents that target the TH17 pathway are directed at psoriasis or psoriatic arthritis. Two (secukinumab and ustekinumab) have been approved by the FDA. The others (brodalumab, ixekizumab, guselkumab, and tildrakizumab) are in various stages of clinical trials.
These inhibitors of the TH17 cytokines IL17 and IL23 have good safety profiles, and may serve as first-line biologics or as second-line treatments for patients who cannot take or have not benefitted from TNF inhibitors.
Tildrakizumab, another IL-23 inhibitor, has completed dose-ranging studies against psoriasis. New and emerging therapies in psoriasisSemin Cutan Med Surg. 2014;33(2 Suppl 2):S37-41. doi: 10.12788/j.sder.0066.