IL-17 and IL-23 Inhibitors Feature Favorable Safety Profile in Psoriasis, Psoriatic Arthritis

Musculoskeletal Symptoms Predict Psoriatic Arthritis
Musculoskeletal Symptoms Predict Psoriatic Arthritis
IL-17 and IL-23 inhibitors appear to be well tolerated, with good safety profiles; recent findings outlined here may aid clinical decision making when choosing the most appropriate therapy for patients with moderate to severe psoriasis.

Interleukin (IL)-17 and IL-23 inhibitors are associated with a relatively low incidence of adverse effects (AEs) when used for the treatment of psoriasis and psoriatic arthritis, study data published in the Journal of the European Academy of Dermatology and Venereology suggest.

A systematic literature review of phase 3, phase 3b, and open-label extensions of phase 3 trials was performed. Only studies that investigated the use of brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, or tildrakizumab in patients with psoriasis and/or psoriatic arthritis and/or generalized pustular psoriasis and/or erythrodermic psoriasis were included. In the pooled analysis of these studies, researchers assessed the incidence of AEs at 12 weeks, 16 weeks, 24 weeks, and/or 52 weeks. The final analysis included 44 studies, including 3 for brodalumab, 5 for guselkumab, 13 for ixekizumab, 3 for risankizumab, 19 for secukinumab, and 1 for tildrakizumab.

In the pooled analysis, the percentage of patients who experienced any AE after 12 weeks of treatment was 0.57 (95% CI, 0.54-0.60). The percentage of patients with any AE after 16 weeks was 0.56 (95% CI, 0.50-0.62); after 24 weeks, 0.72 (95% CI, 0.66-0.78); and after 52 weeks, 0.80 (95% CI, 0.79-0.81). The most frequently reported AEs across all therapies included infections, nasopharyngitis, and headache. Discontinuation as a result of AEs was low with secukinumab. Injection site reactions were the most prevalent AEs in the ixekizumab-treated population (15.7% after 52 weeks).

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Limitations of the meta-analysis included the variability in which AEs were reported across studies and the variation in time points used across trials for assessing safety.

Based on these data, the researchers concluded that “IL-17 and IL-23 inhibitors appear to be well tolerated with good safety profiles.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Loft ND, Vaengebjerg S, Halling AS, Skov L, Egeberg A. Adverse events with IL-17 and IL-23 inhibitors for psoriasis and psoriatic arthritis: a systematic review and meta-analysis of phase III studies [published online November 13, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.16073