The TNF/IL‐23/IL‐17 axis—Head‐to‐head trials comparing different biologics in psoriasis treatment
Psoriasis is a T cell–mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL‐12 and IL‐23, drive differentiation of pathogenic T cell responses resulting in TNF and...
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| Published in | Scandinavian journal of immunology Vol. 92; no. 4; pp. e12946 - n/a |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford
Wiley Subscription Services, Inc
01.10.2020
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| Abstract | Psoriasis is a T cell–mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL‐12 and IL‐23, drive differentiation of pathogenic T cell responses resulting in TNF and IL‐17 production. These cytokines are an integral part of the TNF/IL‐23/IL‐17 axis, which is responsible for maintaining inflammation in psoriatic skin. Our improved understanding of the immunopathogenesis led to the development of biological drugs in the treatment of moderate‐to‐severe disease. Biologics have revolutionized the management of psoriasis, highlighting the central role of TNF/IL‐23/IL‐17 axis in the physiopathology of the disease. Still, psoriasis usually requires long‐term treatment, aiming to fully remove psoriatic lesions without experiencing adverse events. In this review, we discuss the recent findings of all 27 available head‐to‐head trials investigating the efficacy and safety of systemic and biologic therapies in moderate‐to‐severe psoriasis vulgaris, as it is thought to provide more useful knowledge than placebo intervention alone. According to our evaluation, inhibitors that specifically target IL‐23 or IL‐17 are clinically more beneficial than inhibitors of IL‐12/IL‐23 and TNF. More informative results might be obtained by comparing these more efficient biological agents to each other. In addition, newer therapies for psoriasis using small‐molecule drugs may represent important advances compared to well‐established biologics as these are less expensive and orally administered. |
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| AbstractList | Psoriasis is a T cell–mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL‐12 and IL‐23, drive differentiation of pathogenic T cell responses resulting in TNF and IL‐17 production. These cytokines are an integral part of the TNF/IL‐23/IL‐17 axis, which is responsible for maintaining inflammation in psoriatic skin. Our improved understanding of the immunopathogenesis led to the development of biological drugs in the treatment of moderate‐to‐severe disease. Biologics have revolutionized the management of psoriasis, highlighting the central role of TNF/IL‐23/IL‐17 axis in the physiopathology of the disease. Still, psoriasis usually requires long‐term treatment, aiming to fully remove psoriatic lesions without experiencing adverse events. In this review, we discuss the recent findings of all 27 available head‐to‐head trials investigating the efficacy and safety of systemic and biologic therapies in moderate‐to‐severe psoriasis vulgaris, as it is thought to provide more useful knowledge than placebo intervention alone. According to our evaluation, inhibitors that specifically target IL‐23 or IL‐17 are clinically more beneficial than inhibitors of IL‐12/IL‐23 and TNF. More informative results might be obtained by comparing these more efficient biological agents to each other. In addition, newer therapies for psoriasis using small‐molecule drugs may represent important advances compared to well‐established biologics as these are less expensive and orally administered. Psoriasis is a T cell-mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL-12 and IL-23, drive differentiation of pathogenic T cell responses resulting in TNF and IL-17 production. These cytokines are an integral part of the TNF/IL-23/IL-17 axis, which is responsible for maintaining inflammation in psoriatic skin. Our improved understanding of the immunopathogenesis led to the development of biological drugs in the treatment of moderate-to-severe disease. Biologics have revolutionized the management of psoriasis, highlighting the central role of TNF/IL-23/IL-17 axis in the physiopathology of the disease. Still, psoriasis usually requires long-term treatment, aiming to fully remove psoriatic lesions without experiencing adverse events. In this review, we discuss the recent findings of all 27 available head-to-head trials investigating the efficacy and safety of systemic and biologic therapies in moderate-to-severe psoriasis vulgaris, as it is thought to provide more useful knowledge than placebo intervention alone. According to our evaluation, inhibitors that specifically target IL-23 or IL-17 are clinically more beneficial than inhibitors of IL-12/IL-23 and TNF. More informative results might be obtained by comparing these more efficient biological agents to each other. In addition, newer therapies for psoriasis using small-molecule drugs may represent important advances compared to well-established biologics as these are less expensive and orally administered.Psoriasis is a T cell-mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL-12 and IL-23, drive differentiation of pathogenic T cell responses resulting in TNF and IL-17 production. These cytokines are an integral part of the TNF/IL-23/IL-17 axis, which is responsible for maintaining inflammation in psoriatic skin. Our improved understanding of the immunopathogenesis led to the development of biological drugs in the treatment of moderate-to-severe disease. Biologics have revolutionized the management of psoriasis, highlighting the central role of TNF/IL-23/IL-17 axis in the physiopathology of the disease. Still, psoriasis usually requires long-term treatment, aiming to fully remove psoriatic lesions without experiencing adverse events. In this review, we discuss the recent findings of all 27 available head-to-head trials investigating the efficacy and safety of systemic and biologic therapies in moderate-to-severe psoriasis vulgaris, as it is thought to provide more useful knowledge than placebo intervention alone. According to our evaluation, inhibitors that specifically target IL-23 or IL-17 are clinically more beneficial than inhibitors of IL-12/IL-23 and TNF. More informative results might be obtained by comparing these more efficient biological agents to each other. In addition, newer therapies for psoriasis using small-molecule drugs may represent important advances compared to well-established biologics as these are less expensive and orally administered. |
| Author | Petrovic, Aleksandra ten Bergen, Lisa Lynn Appel, Silke Krogh Aarebrot, Anders |
| Author_xml | – sequence: 1 givenname: Lisa Lynn surname: ten Bergen fullname: ten Bergen, Lisa Lynn organization: Vrije Universiteit Amsterdam – sequence: 2 givenname: Aleksandra surname: Petrovic fullname: Petrovic, Aleksandra email: aleksandra.petrovic@uib.no organization: University of Bergen – sequence: 3 givenname: Anders surname: Krogh Aarebrot fullname: Krogh Aarebrot, Anders organization: University of Bergen – sequence: 4 givenname: Silke orcidid: 0000-0002-2199-2315 surname: Appel fullname: Appel, Silke email: Silke.Appel@uib.no organization: University of Bergen |
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| Copyright | The Authors. Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology The Authors. Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. The Authors. Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology. |
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| SubjectTerms | Biological products biologics Cell differentiation Cytokines Drug development head‐to‐head trials Immunopathogenesis Inflammation Lymphocytes T Oral administration Psoriasis Psoriasis vulgaris TNF/IL‐23/IL‐17 axis Tumor necrosis factor |
| Title | The TNF/IL‐23/IL‐17 axis—Head‐to‐head trials comparing different biologics in psoriasis treatment |
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