Onset of Plaque Psoriasis Treatment Responses With Anti-IL-17/IL-23 Biologic Therapies

Abstract

Background:The impact of psoriasis on quality of life arises from both physical symptoms, such as pain and pruritus, and the psychosocial effects of the often highly visible lesions. For patients with moderate-to-severe psoriasis seeking amelioration of these symptoms, time to onset of treatment response is an important consideration when determining an appropriate therapeutic approach with their healthcare provider. Methods: In this review, we discuss the fluidity of the definition of rapid response and time-to-response expectations of patients with psoriasis receiving biologic therapies. Next, we focus on time to response of brodalumab, a human anti-interleukin-17 receptor A monoclonal antibody, in patients with moderate-to-severe psoriasis, as measured by the psoriasis area and severity index and the psoriasis symptom inventory. Brodalumab previously exhibited efficacy and safety in treatment of moderate-to-severe psoriasis in three phase 3 trials (AMAGINE-1/-2/-3), warranting further characterization of its ability to meet patient needs regarding rapidity of treatment response. Finally, we place time to response of brodalumab in the context of the current treatment landscape of biologic therapies for psoriasis (particularly those targeting the interleukin-17/interleukin-23 axis). Results: Direct and indirect comparisons with other interleukin-targeting drugs support brodalumab's more rapid onset of treatment effects, including skin clearance and relief of itch and pain. Conclusion: Brodalumab induces a rapid treatment response in patients with moderate-to-severe psoriasis and may promote earlier improvements in quality of life.

Efficacy of anti‐IL‐23 and anti‐IL‐17 after adalimumab failure in psoriatic patients

“…Despite the higher mean PASI in ADA‐experienced patients treated with IL‐17 inhibitors and the faster rate in bio‐naive patients, there were no significant differences in the achievement of PASI100, PASI90 and PASI < 3, except at week 16, where ADA‐experienced patients on an anti‐IL23 agent performed less well than bio‐naive patients treated with the same drug, this is in line with registration studies 19 . A comparison of ADA‐experience showed the better performance of IL‐23 agents, as expected by evidences in literature, 20 although the difference was not significant. Similar results were confirmed in multivariate analysis.…”

Multi‐failure psoriasis patients: characterization of the patients and response to biological therapy in a multicenter Italian cohort

“…The faster efficacy of IL‐17 inhibitors compared to IL‐23 inhibitors is in line with the results reported in registration and real‐life studies in the literature. The progressive improvement in the response to anti‐IL‐23 is also in line with previous observations 10,11 . Although from a treat‐to‐target perspective, the therapeutic switch should be avoided, preferring effective clinical response with the first biological line used, the switch from anti‐TNFα to IL‐17 and IL‐23 inhibitors did not limit the therapeutic response in trials and real‐life studies 12,13 …”

“…The progressive improvement in the response to anti-IL-23 is also in line with previous observations. 10,11 Although from a treat-totarget perspective, the therapeutic switch should be avoided, preferring effective clinical response with the first biological line used, the switch from anti-TNFa to IL-17 and IL-23 inhibitors did not limit the therapeutic response in trials and real-life studies. If the interclass switch between IL-17 or IL-17RA inhibitors seems to show good efficacy, similar results do not seem to be achieved with the switch between TNFa inhibitors; this is due to the different causes of primary and secondary failure.…”