Serum Krebs von den Lungen‐6 levels in psoriatic patients under treatment with biologics

Iwata, Hiroaki; Haga, Naoya; Sugai, Tatsuro; Fujita, Yasuyuki

doi:10.1111/1346-8138.15665

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…We and Iwata et al . demonstrated that SEC did not decrease KL‐6 levels in the overall study population, 18,19 while, Chijiwa et al demonstrated that SEC decreased KL‐6 levels in a high baseline KL‐6 group 20 . In line with their findings, our study indicates that the effect of anti‐IL‐17 biologics on KL‐6 levels is more evident in the high baseline KL‐6 group than in the overall study population.…”

Section: Discussionsupporting

confidence: 86%

Effect of anti‐interleukin‐17 biologics on Krebs von den Lungen‐6 level in patients with psoriasis

Hara

Miyagawa

Araya

et al. 2021

The Journal of Dermatology

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Psoriasis is a chronic inflammatory cutaneous disease characterized by hyperplasia of the epidermis and infiltration of inflammatory cells. 1 Although the precise molecular mechanism of psoriasis is still unknown, increasing recent evidence suggests that T-helper (Th)17 cells and their product interleukin (IL)-17 play pivotal roles in inflammation during psoriasis pathogenesis. 1,2 The IL-17 family comprises six ligands (IL-17A-F) and five receptors. [1][2][3] Proinflammatory IL-17A and IL-17F are highly expressed in psoriatic lesions. 1,2,4 IL-17F acts in a similar manner in terms of inflammation but has weaker potential than IL-17A. 2 The receptors for IL-17A and IL-17F are heteromeric receptor complexes including IL-17 receptor A. [1][2][3] Hence, IL-17A and IL-17 receptor A are major targets for the anti-inflammatory treatment of psoriasis. Currently, three anti-IL-17 biological agents for psoriasis are available in Japan. Secukinumab (SEC) and ixekizumab (IXE) are monoclonal antibodies targeting IL-17A, and brodalumab (BRO) is a fully human monoclonal antibody

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Section: Discussionsupporting

confidence: 86%

Effect of anti‐interleukin‐17 biologics on Krebs von den Lungen‐6 level in patients with psoriasis

Hara

Miyagawa

Araya

et al. 2021

The Journal of Dermatology

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“…Iwata et al . showed that neither IL‐17 inhibitors nor IL‐23 inhibitors had any significant impact on the serum KL‐6 level 19 . Because increased serum KL‐6 levels were observed with biologic treatments for psoriasis, especially with TNF inhibitors, it is necessary to monitor the KL‐6 level during treatment with biologics and rule out the occurrence of IP.…”

Section: Discussionmentioning

confidence: 99%

Real‐world blood examination screening data before initiation of biologics for psoriasis patients

Ozaki

Ichiyama

Ito

et al. 2022

The Journal of Dermatology

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Psoriasis is a chronic immune‐mediated inflammatory skin disease characterized by hyperproliferation of epidermal keratinocytes. Biologics have been available for the treatment of patients with refractory psoriasis since 2010 in Japan, and as of December 2021, 10 biologics were available. The Biologics Review Committee of the Japanese Dermatological Association for Psoriasis recommends blood examination tests for antinuclear antibodies (ANA), Krebs von den Lugen (KL)‐6, hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (HBsAb), hepatitis B core antibodies (HBcAb), hepatitis C virus (HCV) antibodies, HIV antibodies, human T‐cell leukemia virus (HTLV)‐1 antibodies, β‐D‐glucan, and the T‐cell spot (T‐SPOT) test before initiation of biologics at screening. In this study, we evaluated the use of biologics for 127 psoriasis patients and the blood examination screening data before initiation of biologics in the real‐world setting. Tumor necrosis factor inhibitors, interleukin (IL)‐17 inhibitors and IL‐23 inhibitors were initiated for 54 (42.5%), 36 (28.3%), and 37 (29.1%) patients, respectively. The numbers of patients positive for ANA, HBsAg, HBsAb, HBcAb, HCV antibody, HIV antibody, HTLV‐1 antibody, and T‐SPOT were 27 (21.3%), 0 (0%), 22 (17.3%), 20 (15.7%), three (2.4%), zero (0%), one (0.8%), and 4 (3.1%), respectively. The numbers of patients whose KL‐6 and β‐D‐glucan levels were higher than the reference values were seven (5.5%) and seven (5.5%), respectively. In the real‐world setting, it is sometimes unavoidable to use biologics for those patients with abnormal data although careful monitoring is necessary.

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Change in Serum KL-6 Level during Biologic Treatment for Psoriasis

et al. 2023

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Background: We previously analyzed data from blood examination screenings, including serum Krebs von den Lungen (KL)-6 level, before starting biologic treatment for psoriasis in a real-world setting. However, we did not follow change in KL-6 level after the initiation of biologics. Furthermore, there has been no follow-up study of certolizumab pegol, risankizumab, or tildrakizumab. This study evaluated change in serum KL-6 levels in patients during treatment with biologics, including certolizumab pegol, risankizumab, and tildrakizumab. Methods:We analyzed data from 111 patients. Change in KL-6 level was regarded as significant if it increased to greater than 500 U/mL at least once and if the maximum level after treatment with biologics was at least 1.5 times that of the baseline level.Results: KL-6 level significantly changed during treatment with TNF inhibitors, IL-17 inhibitors, and IL-23 inhibitors in 9 (20.9%), 2 (6.3%), and 2 (5.6%) patients, respectively. Mean age, mean baseline KL-6 level, and frequency of TNF inhibitor use were higher in patients with a significant change in KL-6 level than those in patients without a significant change. Ten patients had minor interstitial changes on chest CT scans but no clinical signs suggesting interstitial pneumonia.Conclusions: Older patients with psoriasis and high baseline KL-6 levels must be carefully monitored during treatment with biologics, especially TNF inhibitors. Monitoring of KL-6 level and chest CT scans is necessary to exclude the possibility of drug-induced interstitial pneumonia.

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Serum Krebs von den Lungen‐6 levels in psoriatic patients under treatment with biologics

Cited by 3 publications

References 14 publications

Effect of anti‐interleukin‐17 biologics on Krebs von den Lungen‐6 level in patients with psoriasis

Effect of anti‐interleukin‐17 biologics on Krebs von den Lungen‐6 level in patients with psoriasis

Real‐world blood examination screening data before initiation of biologics for psoriasis patients

Change in Serum KL-6 Level during Biologic Treatment for Psoriasis

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