Acute generalized pustular psoriasis successfully treated with the IL‐23p19 antibody risankizumab

Heyer, Sarah; Seiringer, Peter; Eyerich, Stefanie; Pilz, Anna Caroline; Steimle-Grauer, Susanne Annette; Eyerich, Kilian; Biedermann, Tilo; Böhner, Alexander

doi:10.1111/ddg.14857

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…To the best of our knowledge, this is the first study comparing the use of IL-17 and IL-23 inhibitors among patients with PP or EP and utilizes the largest published sample of EP and PP patients treated with anti-IL-23 agents in a real-life setting. Data concerning the effects of IL-23 inhibitors on these subtypes of psoriasis have previously been limited to a few clinical trials, case reports, and case series [ 4 , 5 , 6 , 7 , 8 ]. Cytokines such as IL-17A, IL-23, tumour necrosis factor alpha, and their interferons are overexpressed in GPP and chronic plaque psoriasis lesions [ 9 ].…”

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confidence: 99%

“…It is therefore likely to be available for use in Europe in the not-too-distant future [ 10 ]. One recent fluorescence-activated cell sorting study of the skin lesions associated with these diseases has shown that the proportion of IL-17A-expressing lymphocytes is lower in GPP than in chronic plaque psoriasis, whereas the percentages of IL-23-producing cells are comparable [ 8 ]. However, Bissonnette et al suggest that IL-17A may play an important role in the pathogenesis of PPP, whereas IL-23 expression in PPP may not differ significantly from that observed in other forms of psoriasis [ 11 ].…”

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confidence: 99%

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Interleukin-17 vs. Interleukin-23 Inhibitors in Pustular and Erythrodermic Psoriasis: A Retrospective, Multicentre Cohort Study

Avallone

Maronese

Murgia

et al. 2023

JCM

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Pustular and erythrodermic psoriasis are rare and difficult-to-treat conditions. It has recently been shown that interleukin (IL)-17 inhibitors can be very effective among patients with these forms of psoriasis; however, the potential of IL-23 inhibitors is largely unknown. The aim of this multicentre, retrospective study was to compare the safety, effectiveness, and drug survival of IL-17 and IL-23 inhibitors among patients affected by these rare forms of psoriasis. The study involved 27 patients with erythrodermic psoriasis and 59 with pustular psoriasis (36 with generalised pustular psoriasis and 23 with palmoplantar pustular psoriasis) treated with an IL-17 or IL-23 inhibitor. The effectiveness of the two drug classes was assessed using the disease-specific Psoriasis Area Severity Index (PASI) and the Investigator Global Assessment, which were evaluated at different time points. There was a consistent trend towards a higher rate of PASI 100 responses in the patients treated with IL-17 inhibitors compared with those treated with IL-23 inhibitors, and the other efficacy outcomes showed a similar trend. There was no significant between-drug class difference in efficacy at any of the time points in the erythrodermic psoriasis cohort, whereas PASI 90 and PASI 100 response rates were significantly higher among the pustular psoriasis patients receiving IL-17 inhibitors at week 12 (IL-23 19% vs. IL-17 54% and IL-23 6% vs. IL-17 40%, respectively) and the percentage of responders to IL-17 inhibition was significantly higher at week 24 (IL-23 25% vs. IL-17 74%). In conclusion, it is therefore reasonable to assume that IL-17 and IL-23 inhibitors are both effective when treating pustular and erythrodermic psoriasis.

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confidence: 99%

mentioning

confidence: 99%

Interleukin-17 vs. Interleukin-23 Inhibitors in Pustular and Erythrodermic Psoriasis: A Retrospective, Multicentre Cohort Study

Avallone

Maronese

Murgia

et al. 2023

JCM

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“…2 Seither erschienen in dieser Zeitschrift Publikationen zur Psoriasis in dreistelliger Zahl. In jüngster Zeit umspannen die Themen grundlegende pathophysiologische Aspekte, [3][4][5] therapeutische Ansätze, [6][7][8][9][10][11] epidemiologische Fragen, 12 diagnostische und klinische Entwicklungen, [13][14][15] psychosoziale Aspekte, [16][17][18] bis hin zu Versorgungsforschung und Registerstudien. [19][20][21][22] Empfehlungen zur praktischen Umsetzung neuer Erkenntnisse kulminieren schließlich in Leitlinien.…”

Section: Wo Stehen Wir?unclassified

Aktuelle Entwicklungen und Perspektiven bei Psoriasis

Schön

Wilsmann‐Theis

2023

J Deutsche Derma Gesell

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ZusammenfassungDie Erforschung kaum einer anderen Erkrankung hat so grundlegend neue Erkenntnisse über immunologischen Regulationen und gleichzeitig eine derart rasante Entwicklung innovativer Therapien hervorgebracht wie das Studium der Psoriasis. In dieser kurzen Übersichtsarbeit umreißen wir die Grundzüge der aktuellen Psoriasisforschung unter besonderer Berücksichtigung pathophysiologischer Vorgänge und der Meilensteine bei der Zulassung verschiedener Biologika und niedermolekularer Pharmaka. Nicht zuletzt durch die Psoriasisforschung verstehen wir das Zusammenspiel der Komponenten des angeborenen und des adaptiven Immunsystems immer besser. Neue Therapeutika greifen dabei an entscheidenden Punkten in regulatorische Netzwerke ein. Ausgehend vom derzeitigen Kenntnisstand skizzieren wir einige aus unserer Sicht wesentliche zukünftige Forschungsrichtungen sowie therapeutische und klinische Entwicklungen im Bereich der Psoriasis. Diese reichen von der Erforschung genetischer, epigenetischer, zellulärer und immunologischer Mechanismen über die Untersuchung spezifischer klinischer Formen der Psoriasis und individueller systemischer Auswirkungen der Krankheit sowie ihrer Behandlung bis hin zur Einbeziehung von Big Data und künstlicher Intelligenz. Ziele sind ein ganzheitliches Verständnis der Psoriasis von der molekularen bis zur organismischen und gesellschaftlichen Ebene und darauf aufbauend individualisierte Präventions‐ und Behandlungsstrategien. Trotz beeindruckender Fortschritte muss die Psoriasisforschung sowohl im kleinen als auch im großen Maßstab weiterentwickelt werden, um den Bedürfnissen von Behandlern und Patienten noch besser gerecht zu werden.

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“…Generalized pustular psoriasis is a rare, life-threatening systemic inflammatory disease that features sterile pustules on the erythema over a large body area. [2][3][4] Generalized pustular psoriasis is known as an autoinflammatory keratinization disease that develops with genetic autoinflammatory pathogenesis. Variants in genes including IL36RN, CARD14, AP1S3, MPO, and SERPINA-3 were reported to be causative or predisposing factors for GPP.…”

Section: Dear Editorsmentioning

confidence: 99%

Generalized pustular psoriasis that developed in a patient with an NFKB2 variant

Wada,

Namiki,

Ebata

et al. 2023

J Deutsche Derma Gesell

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Acute generalized pustular psoriasis successfully treated with the IL‐23p19 antibody risankizumab

Cited by 8 publications

References 12 publications

Interleukin-17 vs. Interleukin-23 Inhibitors in Pustular and Erythrodermic Psoriasis: A Retrospective, Multicentre Cohort Study

Interleukin-17 vs. Interleukin-23 Inhibitors in Pustular and Erythrodermic Psoriasis: A Retrospective, Multicentre Cohort Study

Aktuelle Entwicklungen und Perspektiven bei Psoriasis

Generalized pustular psoriasis that developed in a patient with an NFKB2 variant

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