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

阿达木单抗 医学 银屑病性关节炎 银屑病 内科学 白细胞介素17 白细胞介素23 胃肠病学 肿瘤坏死因子α 免疫学 细胞因子
作者
Luca Mastorino,Sara Susca,Caterina Cariti,Niccolò Sliquini,Anna Verrone,Elena Stroppiana,M. Ortoncelli,Paolo Dapavo,Simone Ribero,Pietro Quaglino
出处
期刊:Journal of The European Academy of Dermatology and Venereology [Wiley]
卷期号:37 (9): 1848-1853 被引量:16
标识
DOI:10.1111/jdv.19135
摘要

Many national guidelines at the European level recommend first-line therapy based on the anti-TNF-alpha adalimumab for treatment of psoriasis and psoriatic arthritis, mainly for economic reasons. Consequently, patients being treated with newer IL-17 and IL-23 inhibitors underwent previous unsuccessful first-line adalimumab-based therapy.Evaluate the efficacy and safety of IL-17 and IL-23 inhibitors after treatment with adalimumab compared to adalimumab-naive psoriatic patients.We retrospectively analysed 1053 psoriatic patients treated with anti-IL17 and anti-IL23 agents, which included 68 and 24 adalimumab-experienced and 399 and 260 bio-naive patients. Efficacy was assessed with mean PASI, PASI90, PASI100, and <3.Concerning the achieving of PASI100, PASI90 and PASI < 3 in patients treated with anti-IL17 agents, no significant differences were observed between adalimumab-experienced and bio-naive patients. In patients treated with an anti-IL-23 agent, a faster response was observed in bio-naive patients, with PASI < 3 significantly higher than ADA-experienced patients at 16 weeks (77% vs. 58% p = 0.048). In a sub-analysis that evaluated the performance of anti-IL17 and anti-IL23 agents in adalimumab-experienced patients with a history of secondary failure, no significant differences were found. In multivariate analysis of PASI100, only anti-IL-17 therapy appeared to have a negative impact at 52 weeks (OR: 0.54 p = 0.04) independently of previous treatment. For PASI90, type of treatment and bio-naïve status did not seem to have an impact at any time point.Anti-IL 23 and anti-IL 17 agents are not significantly different in terms of efficacy in bio-naive patients or as second-line therapy after failure with a biosimilar or originator adalimumab.
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