Efficacy of switches within the class of IL ‐17 inhibitors: An analysis of data from the Czech nationwide registry of psoriatic patients receiving biological/targeted therapy ( BIOREP )

Abstract

The IL-17 cytokine family encompasses six different homodimers and heterodimers referred to as IL-17A-F. Due to some differences in the mechanism of IL-17 inhibition, aninsufficient effect of one IL-17 inhibitor does not necessarily imply lack of efficacy of the other agent of the same class. Aim of study was analysis of the success rate of switches among IL-17 inhibitors (secukinumab, ixekizumab, and brodalumab) in patients treated in the Czech Republic. Data were obtained from the Czech nationwide registry of psoriatic patients receiving biological/targeted therapy (BIOREP). Our analysis involved data of a total of 90 patients with severe chronic plaque psoriasis and baseline PASI scores >10 both prior to first-line biological therapy initiation and after switch to another agent of the class of IL-17 inhibitors. The most effective switch was that from secukinumab to brodalumab, with PASI 90 reached by 64.7% and 73.3% of patients at weeks 12 and 24. Among patients switched from secukinumab to ixekizumab target PASI 90 responses were achieved (at weeks 12 and 24) by 41.2% and 55.2% of patients. Among patients switched from ixekizumab to brodalumab target PASI 90 responses were achieved, at the above time points, by 30.8% and 38.5% of patients. Our analysis showed a high success rate of switches from secukinumab to ixekizumab and brodalumab, followed by the ixekizumab-to-brodalumab switch. Importantly, the therapeutic response and success rates of individual switches are independent of the patient's body weight and presence of psoriatis arthritis.

Real‐world drug survival of Brodalumab, in patients with psoriasis switched from Ixekizumab: Results of a single centre retrospective study (BroSwitch)

“…At the moment of data collection, 135 EMRs were selected via pharmacy records, of which 91 were included in the study. Most patients were excluded because they did not use Ixekizumab before Brodalumab (27). Ten patients were excluded because they had diagnosed PsA before the switch, since Brodalumab is not registered to treat PsA.…”

“…We did indeed see initial favourable efficacy. Other information come from registries, like the BioRep 27 . Where patients who failed on one anti‐IL17 Biological were switched to another.…”

“…Other information come from registries, like the BioRep. 27 Where patients who failed on one anti-IL17 Biological were switched to another. With favourable responses at Week 12 and 24, but no drug survival data is available.…”

Drug Survival of Tumor Necrosis Factor-Alpha Inhibitors and Switched Subsequent Biologic Agents in Patients with Psoriasis: A Retrospective Study

“…According to reports in the literature, when patients need to change TNF inhibitors, switching to another TNF inhibitor or switching to inhibitors of different classes can be both safe and effective options in cases of insufficient response or intolerance [ 21 , 22 ], especially when the first TNF inhibitor did not show primary failure [ 23 ]. Moreover, there are many reports of successful intra-class switches among TNF inhibitors and among IL-17 inhibitors [ 21 , 22 , 24 – 26 ]. In contrast, in a study of psoriatic arthritis, the response rate was significantly lower for the second switcher than for the first switcher when the patient switched among TNF inhibitors more than once [ 27 ].…”