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Zheng C, He X, Tang X. Multiple Mucosal Ulcers Induced by Ixekizumab: A Case Report. Ann Otol Rhinol Laryngol 2024; 133:750-754. [PMID: 38742650 DOI: 10.1177/00034894241254431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVES Ixekizumab, an interleukin (IL)-17A inhibitor, exerts its therapeutic effects in psoriasis by inhibiting the interleukin (IL)-17 signaling pathway. Common adverse reactions to ixekizumab include injection site reactions and upper respiratory tract infections (URIs), while occurrences of inflammatory bowel disease (IBD) and multiple mucosal ulcers are infrequent. We present a case of a 51-year-old man who developed multiple mucosal ulcers after ixekizumab treatment. METHODS A 51-year-old man presented to our hospital with a 1-month history of pharyngalgia. The flexible laryngoscope displayed mild hyperemia in the pharyngeal mucosa and tonsils, redness and swelling of the epiglottis, as well as multiple ulcers in the oral cavity, uvula, and epiglottis. These ulcers did not improve with conventional treatment. RESULTS Upon evaluation, the ulcers were an immune-related adverse event induced by ixekizumab. Consequently, a decision was made to discontinue the drug and initiate a therapeutic regimen including corticosteroids and thalidomide. Eventually, the patient's symptoms abated. CONCLUSIONS Biologics are now becoming increasingly popular in psoriasis. It is vital for clinicians to be aware of this potential adverse event and to identify and intervene early to alleviate patients' suffering.
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Affiliation(s)
- Cheng Zheng
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiao He
- The Department of Otolaryngology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Xuxia Tang
- The Department of Otolaryngology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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2
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Zhang L, Li X, Xu X, Le Y, Cao H, Zhang J, Xue F, Hu M, Xia Y, Pan M, Chen L, Zheng J. Ixekizumab-induced urticaria is associated with the short duration of remission in psoriasis by activation of mast cells. J Am Acad Dermatol 2024; 90:970-976. [PMID: 38244613 DOI: 10.1016/j.jaad.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Mast cell degranulation plays a pivotal role in urticaria and is also an early histologic characteristic of psoriasis. However, whether the activation of mast cells contributes to psoriasis recurrence after discontinuation of interleukin (IL)-17A blockers remains unclear. OBJECTIVE To investigate the role of mast cells in ixekizumab treatment-associated urticaria (ITAUR) and assess the effect of urticaria eruption on psoriasis relapse. METHODS A retrospective analysis was performed on biopsies of patients who experienced psoriasis relapse after discontinuation of ixekizumab. Transcriptomic and histopathologic features were assessed. Patterns were compared between patients with ITAUR and nonurticaria (NUR) as well as psoriasis-like mice with mast cell activation or inactivation. RESULTS Patients with ITAUR experienced early relapse compared with NUR group after treatment withdrawal. Transcriptomic and histopathologic analyses revealed that patients with ITAUR had an elevated proportion of mast cells in resolved skin. Especially, the proportion of IL-17A+ mast cells was inversely correlated with the duration of remission. LIMITATIONS The mechanism of mast cell activation in ITAUR has not been precisely elucidated. CONCLUSION Ixekizumab treatment increases IL-17A+ mast cells in lesions of ITAUR, which is associated with early psoriasis relapse after ixekizumab withdrawal.
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Affiliation(s)
- Li Zhang
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xintian Xu
- Key Laboratory of Molecular Virology and Immunology, Institute Pasteur of Shanghai, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Shanghai, China
| | - Yunchen Le
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Han Cao
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayi Zhang
- Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Xue
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengyan Hu
- Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuhan Xia
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Meng Pan
- Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lihong Chen
- Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Jie Zheng
- Laboratory of Dermatoimmunology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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3
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Sandeep, Shinde SH, Ahmed S, Sharma SS, Pande AH. Engineered polyspecific antibodies: A new frontier in the field of immunotherapeutics. Immunology 2024; 171:464-496. [PMID: 38140855 DOI: 10.1111/imm.13743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
The 21st-century beginning remarked with the huge success of monospecific MAbs, however, in the last couple of years, polyspecific MAbs (PsAbs) have been an interesting topic and show promise of being biobetter than monospecific MAbs. Polyspecificity, in which a single antibody serves multiple specific target binding, has been hypothesized to contribute to the development of a highly effective antibody repertoire for immune defence. This polyspecific MAb trend represents an explosion that is gripping the whole pharmaceutical industry. This review is concerned with the current development and quality enforcement of PsAbs. All provided literature on monospecific MAbs and polyspecific MAbs (PsAbs) were searched using various electronic databases such as PubMed, Google Scholar, Web of Science, Elsevier, Springer, ACS, Google Patent and books via the keywords Antibody engineering, Polyspecific antibody, Conventional antibody, non-conventional antibody, and Single domain antibody. In the literature, there are more than 100 different formats to construct PsAb by quadroma technology, chemical conjugation and genetic engineering. Till March 2023, nine PsAb have been approved around the world, and around 330 are in advanced developmental stages, showing the dominancy of PsAb in the growing health sector. Recent advancements in protein engineering techniques and the fusion of non-conventional antibodies have made it possible to create complex PsAbs that demonstrate higher stability and enhanced potency. This marks the most significant achievement for cancer immunotherapy, in which PsAbs have immense promise. It is worth mentioning that seven out of the nine PsAbs have been approved as anti-cancer therapy. As PsAbs continue to acquire prominence, they could pave the way for the development of novel immunotherapies for multiple diseases.
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Affiliation(s)
- Sandeep
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Suraj H Shinde
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Sakeel Ahmed
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Shyam Sunder Sharma
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
| | - Abhay H Pande
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
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Heffernan A, Shafiee A, Chan T, Sparanese S, Thamboo A. Non-Type 2 and Mixed Inflammation in Chronic Rhinosinusitis and Lower Airway Disease. Laryngoscope 2024; 134:1005-1013. [PMID: 37615304 DOI: 10.1002/lary.30992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE The aim was to discuss the role of non-type 2 inflammation in patients diagnosed with chronic rhinosinusitis (CRS) and comorbid lower airway disease. DATA SOURCES Medline, Embase, National Institute for Health and Care Excellence, TRIP Database, ProQuest, Clinicaltrials.gov, Cochrane Central Registry of Controlled Trials, Web of Science, government and health organizations, and graduate-level theses. REVIEW METHODS This scoping review followed PRISMA-ScR guidelines. Search strategy was peer-reviewed by medical librarians. Studies were included if they utilized airway sampling, non-type 2 cytokines, and patients with CRS and lower airway disease. RESULTS Twenty-seven from 7060 articles were included. In patients with CRS and comorbid asthma, aspirin-exacerbated respiratory disease (AERD), and chronic obstructive pulmonary disease (COPD)/bronchiectasis, 60% (n = 12), 33% (n = 2), and 100% (n = 1), respectively, demonstrated mixed or non-type 2 endotypes. Comorbid CRS and asthma produced type 1 (n = 1.5), type 2 (n = 8), type 3 (n = 1), mixed type 1/2 (n = 1), and mixed type 1/2/3 (n = 8.5) endotype shifts. AERD demonstrated type 2 (n = 4), mixed type 2/3 (n = 1), and mixed type 1/2/3 (n = 1) endotype shifts. CRS with COPD or bronchiectasis demonstrated a mixed 1/2 (n = 1) endotype shift. CONCLUSION Type 2 disease has been extensively reviewed due to advent biologics targeting type 2 inflammation, but outcomes may be suboptimal due to the presence of non-type 2 inflammation. A proportion of patients with CRS and comorbid lower airway disease demonstrated mixed and non-type 2 endotype shifts. This emphasizes that patients with unified airway disease may have forms of inflammation beyond classical type 2 disease which could inform biologic development. Laryngoscope, 134:1005-1013, 2024.
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Affiliation(s)
- Austin Heffernan
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Amir Shafiee
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Teffran Chan
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Sydney Sparanese
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Andrew Thamboo
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
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5
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Gao Y, Cai L, Wu Y, Jiang M, Zhang Y, Ren W, Song Y, Li L, Lei Z, Wu Y, Zhu L, Li J, Li D, Li G, Luo C, Tao L. Emerging functions and therapeutic targets of IL-38 in central nervous system diseases. CNS Neurosci Ther 2024; 30:e14550. [PMID: 38334236 PMCID: PMC10853902 DOI: 10.1111/cns.14550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024] Open
Abstract
Interleukin (IL)-38 is a newly discovered cytokine of the IL-1 family, which binds various receptors (i.e., IL-36R, IL-1 receptor accessory protein-like 1, and IL-1R1) in the central nervous system (CNS). The hallmark physiological function of IL-38 is competitive binding to IL-36R, as does the IL-36R antagonist. Emerging research has shown that IL-38 is abnormally expressed in the serum and brain tissue of patients with ischemic stroke (IS) and autism spectrum disorder (ASD), suggesting that IL-38 may play an important role in neurological diseases. Important advances include that IL-38 alleviates neuromyelitis optica disorder (NMOD) by inhibiting Th17 expression, improves IS by protecting against atherosclerosis via regulating immune cells and inflammation, and reduces IL-1β and CXCL8 release through inhibiting human microglial activity post-ASD. In contrast, IL-38 mRNA is markedly increased and is mainly expressed in phagocytes in spinal cord injury (SCI). IL-38 ablation attenuated SCI by reducing immune cell infiltration. However, the effect and underlying mechanism of IL-38 in CNS diseases remain inadequately characterized. In this review, we summarize the biological characteristics, pathophysiological role, and potential mechanisms of IL-38 in CNS diseases (e.g., NMOD, Alzheimer's disease, ASD, IS, TBI, and SCI), aiming to explore the therapeutic potential of IL-38 in the prevention and treatment of CNS diseases.
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Affiliation(s)
- Yuan Gao
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
- Department of NeurosurgeryPennsylvania State University College of MedicineState CollegePennsylvaniaUSA
- Department of Forensic ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Luwei Cai
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Yulu Wu
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Min Jiang
- Department of Forensic Medicine, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yidan Zhang
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Wenjing Ren
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Yirui Song
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Lili Li
- Department of Child and Adolescent HealthcareChildren's Hospital of Soochow UniversitySuzhouChina
| | - Ziguang Lei
- Department of Forensic ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Youzhuang Wu
- Department of Forensic ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Luwen Zhu
- Department of Forensic ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Jing Li
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Dongya Li
- Department of OrthopedicsThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
| | - Guohong Li
- Department of NeurosurgeryPennsylvania State University College of MedicineState CollegePennsylvaniaUSA
| | - Chengliang Luo
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
| | - Luyang Tao
- Department of Forensic Medicine, School of Basic Medicine and Biological SciencesSoochow UniversitySuzhouChina
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Li L, Lu J, Liu J, Wu J, Zhang X, Meng Y, Wu X, Tai Z, Zhu Q, Chen Z. Immune cells in the epithelial immune microenvironment of psoriasis: emerging therapeutic targets. Front Immunol 2024; 14:1340677. [PMID: 38239345 PMCID: PMC10794746 DOI: 10.3389/fimmu.2023.1340677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024] Open
Abstract
Psoriasis is a chronic autoimmune inflammatory disease characterized by erroneous metabolism of keratinocytes. The development of psoriasis is closely related to abnormal activation and disorders of the immune system. Dysregulated skin protective mechanisms can activate inflammatory pathways within the epithelial immune microenvironment (EIME), leading to the development of autoimmune-related and inflammatory skin diseases. In this review, we initially emphasized the pathogenesis of psoriasis, paying particular attention to the interactions between the abnormal activation of immune cells and the production of cytokines in psoriasis. Subsequently, we delved into the significance of the interactions between EIME and immune cells in the emergence of psoriasis. A thorough understanding of these immune processes is crucial to the development of targeted therapies for psoriasis. Finally, we discussed the potential novel targeted therapies aimed at modulating the EIME in psoriasis. This comprehensive examination sheds light on the intricate underlying immune mechanisms and provides insights into potential therapeutic avenues of immune-mediated inflammatory diseases.
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Affiliation(s)
- Lisha Li
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai University, School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Jiaye Lu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai University, School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Jun Liu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Junchao Wu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai University, School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Xinyue Zhang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Yu Meng
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Xiying Wu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Zongguang Tai
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Quangang Zhu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai University, School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
| | - Zhongjian Chen
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai University, School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of External Chinese Medicine, Shanghai, China
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7
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Mastorino L, Susca S, Cariti C, Verrone A, Stroppiana E, Ortoncelli M, Dapavo P, Ribero S, Quaglino P. "Superresponders" at biologic treatment for psoriasis: A comparative study among IL17 and IL23 inhibitors. Exp Dermatol 2023; 32:2187-2188. [PMID: 36541075 DOI: 10.1111/exd.14731] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Luca Mastorino
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Sara Susca
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Caterina Cariti
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Anna Verrone
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Elena Stroppiana
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Michela Ortoncelli
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Dapavo
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
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Bilal H, Khan MN, Khan S, Fang W, Chang W, Yin B, Song NJ, Liu Z, Zhang D, Yao F, Wang X, Wang Q, Cai L, Hou B, Wang J, Mao C, Liu L, Zeng Y. Risk of candidiasis associated with interleukin-17 inhibitors: Implications and management. Mycology 2023; 15:30-44. [PMID: 38558839 PMCID: PMC10977001 DOI: 10.1080/21501203.2023.2265664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/27/2023] [Indexed: 04/04/2024] Open
Abstract
The application of interleukin-17 (IL-17) inhibitors, including secukinumab, ixekizumab, brodalumab, and bimekizumab, are associated with elevated risk of candidiasis. These medications interfere with the IL-17 pathway, which is essential for maintaining mucosal barriers and coordinating the immune response against Candida species. The observational data and clinical trials demonstrate the increased incidence of candidiasis in individuals treated with IL-17 inhibitors. Brodalumab and bimekizumab pose a greater risk than secukinumab in eliciting candidiasis, whereas the data regarding ixekizumab are equivocal. Higher doses and prolonged treatment duration of IL-17 inhibitors increase the risk of candidiasis by compromising the immune response against Candida species. Prior to prescribing IL-17 inhibitors, healthcare professionals should comprehensively evaluate patients' medical histories and assess their risk factors. Patients should be educated on the signs and symptoms of candidiasis to facilitate early detection and intervention. Future research should focus on identifying the risk factors associated with candidiasis in patients receiving IL-17 inhibitors. Prospective studies and long-term surveillance are required to explore the impact of specific inhibitors on the incidence and severity of candidiasis and to evaluate the effectiveness of combination therapies, such as concurrent use of IL-17 inhibitors and prophylactic antifungal agents.
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Affiliation(s)
- Hazrat Bilal
- Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Muhammad Nadeem Khan
- Faculty of Biological Sciences, Department of Microbiology, Quaid-I-Azam University, Islamabad, Pakistan
| | - Sabir Khan
- Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Wenjie Fang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wenqiang Chang
- School of Pharmacy, Shandong University, Qingdao, Shandong, China
| | - Bin Yin
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Ning-Jing Song
- Department of Dermatology, Tongren Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhongrong Liu
- Department of Dermatology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dongxing Zhang
- Department of Dermatology, Meizhou Dongshan Hospital, Meizhou, Guangdong, China
- Department of Dermatology, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Fen Yao
- Department of Pharmacy, Shantou University School Medical College, Shantou, China
| | - Xun Wang
- Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qian Wang
- Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Lin Cai
- Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Bing Hou
- Department of Clinical Laboratory, Skin and Venereal Diseases Prevention and Control Hospital of Shantou City, Shantou, Guangdong, China
| | - Jiayue Wang
- Department of Dermatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunyan Mao
- Department of Dermatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lingxi Liu
- Department of Dermatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuebin Zeng
- Department of Dermatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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9
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Xiao J, Zhang P, Cai FL, Luo CG, Pu T, Pan XL, Tian M. IL-17 in osteoarthritis: A narrative review. Open Life Sci 2023; 18:20220747. [PMID: 37854319 PMCID: PMC10579884 DOI: 10.1515/biol-2022-0747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023] Open
Abstract
Osteoarthritis (OA) is a painful joint disease that is common among the middle-aged and elderly populations, with an increasing prevalence. Therapeutic options for OA are limited, and the pathogenic mechanism of OA remains unclear. The roles of cytokines and signaling pathways in the development of OA is a current research hot spot. Interleukin (IL)-17 is a pleiotropic inflammatory cytokine produced mainly by T helper 17 cells that has established roles in host defense, tissue repair, lymphoid tissue metabolism, tumor progression, and pathological processes of immune diseases, and studies in recent years have identified an important role for IL-17 in the progression of OA. This narrative review focuses on the mechanisms by which IL-17 contributes to articular cartilage degeneration and synovial inflammation in OA and discusses how IL-17 and the IL-17 signaling pathway affect the pathological process of OA. Additionally, therapeutic targets that have been proposed in recent years based on IL-17 and its pathway in OA are summarized as well as recent advances in the study of IL-17 pathway inhibitors and the potential challenges of their use for OA treatment.
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Affiliation(s)
- Juan Xiao
- Department of Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi563000, China
| | - Ping Zhang
- The First School of Clinical Medicine, Zunyi Medical University, Zunyi563000, China
| | - Fang-Lan Cai
- Department of Rheumatology and Immunology Department, Zunyi Medical University, Zunyi563000, China
| | - Cheng-Gen Luo
- The First School of Clinical Medicine, Zunyi Medical University, Zunyi563000, China
| | - Tao Pu
- Department of Nephrology and Rheumatology, Moutai Hospital, Renhuai 564500Guizhou, China
| | - Xiao-Li Pan
- Department of Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi563000, China
| | - Mei Tian
- Department of Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi563000, China
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10
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Carmona-Rocha E, Puig L. Ixekizumab for the treatment of moderate-to-severe plaque psoriasis: the first septennium. Immunotherapy 2023; 15:1209-1225. [PMID: 37609785 DOI: 10.2217/imt-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Ixekizumab is a humanized monoclonal antibody that specifically inhibits IL-17A. It has been approved for the treatment of adult and pediatric psoriasis, psoriatic arthritis and axial spondyloarthropathies by the US FDA and the EMA. Phase III trials, post hoc analyses and real-life data have reported its efficacy, effectiveness and safety. This review summarizes the latest evidence on the clinical efficacy, pharmacology and safety profile of ixekizumab for the treatment of moderate-to-severe psoriasis. A literature search was performed for articles published through December 2022. Ixekizumab is one of the most efficacious biologics for psoriasis, with a rapid onset of response, favorable long-term outcomes and an adequate safety profile.
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Affiliation(s)
- Elena Carmona-Rocha
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lluís Puig
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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11
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Xia R, Liu J, Gao Y, Diao Z, Chen D, Zhou C, Zhang Z, Yin Z. Local injection of micro-dose anti-interleukin-17A antibody for palmoplantar pustulosis: A real-world study. Clin Immunol 2023:109694. [PMID: 37433424 DOI: 10.1016/j.clim.2023.109694] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/29/2023] [Accepted: 07/02/2023] [Indexed: 07/13/2023]
Abstract
Palmoplantar pustulosis (PPP), a chronic and stubborn skin disease, is mainly confined to the palms or/and soles, making it possible for localized use of therapeutic antibodies. In this real-world prospective cohort study, 8 patients with PPP received palms/soles injections of ixekizumab (0.8 mg in 0.1 ml) every 2 to 8 weeks due to the COVID-19 pandemic. The treatment endpoint was a 75% improvement from baseline in Palmoplantar Psoriasis Area and Severity Index (PPPASI 75). At week 8, 75%, 50% and 12.5% of 8 patients reached PPPASI 50, PPPASI 75 and PPPASI 90. At week 12, 100%, 67.5% and 25% of 8 patients reached PPPASI 50, PPPASI 75 and PPPASI 90. This is the first study to evaluate the efficacy and safety of local injection of micro-dose ixekizumab for PPP in real clinical practice. A high proportion of patients rapidly achieved PPPASI 75, and maintained long-term efficacy with satisfactory safety.
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Affiliation(s)
- RuiYuan Xia
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Liu
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - YaMei Gao
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - ZiYue Diao
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - DanDan Chen
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - ChaoJing Zhou
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - ZhiQin Zhang
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - ZhiQiang Yin
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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12
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Fabbrocini G, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Megna M, Sampogna F, Travaglini M, Costanzo A, Narcisi A. Brodalumab for the treatment of plaque psoriasis in a real-life setting: a 3 years multicenter retrospective study-IL PSO (Italian landscape psoriasis). Front Med (Lausanne) 2023; 10:1196966. [PMID: 37469659 PMCID: PMC10352451 DOI: 10.3389/fmed.2023.1196966] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Brodalumab is a monoclonal antibody that targets the subunit A of the interleukin-17A receptor (IL17RA), inhibiting the signaling of various isoforms of the IL-17 family. It has been approved for the treatment of moderate-to-severe plaque psoriasis after being evaluated in three Phase-3 trials. However, long-term data on brodalumab in a real-life setting are still limited. Methods The aim of this study was to evaluate the long-term effectiveness and safety of brodalumab in psoriasis. We also assessed the drug survival of brodalumab in a 3 years timespan. We conducted a retrospective multicenter study on 606 patients followed up at 14 Italian dermatology units, all treated with brodalumab according to Italian guidelines. Patients' demographics and disease characteristics were retrieved from electronic databases. At baseline and weeks 12, 24, 52, 104 and 156, we evaluated the psoriasis area and severity index (PASI) score and investigated for adverse events. The proportions of patients reaching 75, 90 and 100% (PASI 75, PASI 90 and PASI 100, respectively) improvement in PASI, compared with baseline, were also recorded. Results At week 12, 63.53% of the patients reached PASI 90 and 49.17% PASI 100. After 3 years of treatment, 65.22% of patients maintained a complete skin clearance, and 91.30% had an absolute PASI of 2 or less. Patients naïve to biological therapies had better clinical responses at weeks 12, 24 and 52. However, after 2 years of treatment, no significant differences were observed. Body mass index did not interfere with the effectiveness of brodalumab throughout the study. No new safety findings were recorded. After 36 months, 85.64% of our patients were still on treatment with brodalumab. Conclusion Our data confirm the effectiveness and the safety of brodalumab in the largest real-life cohort to date, up to 156 weeks.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piergiorgio Malagoli
- Dermatology Unit, Department of Dermatology, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Fabrizio Amoruso
- Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | | | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Damiani
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, Ospedale Santa Chiara, Pisa, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Franchi
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Francesca Maria Gaiani
- Dermatology Unit, Department of Dermatology, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Claudio Guarneri
- Unit of Dermatology, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - Claudia Lasagni
- Department of Specialized Medicine, Dermatological Clinic, University of Modena, Modena, Italy
| | | | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata (IDI) IRCCS, Rome, Italy
| | - Massimo Travaglini
- U.O.S.D. dermatologica—centro per la cura della psoriasi, Ospedale Perrino, Brindisi, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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13
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Jiang Y, Li Y, Huang D, Zhong X, Yu Q, Liang Y, Dang L, Lv C, Lin B, Zhang F, Liang Y, Lu J, Shi Y. Quality of Life Benefit and Clinical Predictors of Complete Skin Clearance in Psoriasis: A Multicenter, Prospective, Real-World Study. Dermatology 2023; 239:802-810. [PMID: 37311426 DOI: 10.1159/000531420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/16/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Newer biologics, such as interleukin (IL)-17 inhibitors, make it possible to achieve complete skin clearance (CSC) in patients with moderate-to-severe psoriasis. However, the clinical meaningfulness and predictive factors of CSC in daily practice have not yet been fully investigated. OBJECTIVE The study was conducted to, first, assess the impact of CSC on quality of life (QoL) improvements compared with treatment responses without clearance and, second, identify clinical parameters as predictors of CSC response in psoriasis patients treated with ixekizumab. METHODS Patients attending 26 dermatology centers across China were recruited into this real-world setting between August 2020 and May 2022. Prospective cohort study in which response to ixekizumab was assessed using the Psoriasis Area and Severity Index (PASI) and Dermatology Quality of Life Index (DLQI). The absolute DLQI score and DLQI (0) response at week 12 were compared between groups achieving various levels of skin clearance. A stepwise logistic regression analysis was applied to identify which baseline clinical characteristics were predictive factors for CSC. RESULTS After 12 weeks of treatment, 226 of 511 (44.2%) patients achieved CSC, defined as 100% improvement in PASI score (PASI-100). A significantly higher proportion of patients with CSC versus almost clear skin (PASI 90-99) achieved DLQI score of 0, corresponding to the experience of no impairment on QoL (54.4% vs. 37.7%, p = 0.001). Females patients were more likely than males to achieve CSC response (odds ratio [OR] = 1.83; 95% confidence interval [CI]: 1.24-2.70), while previous biologic treatment (OR = 0.43; 95% CI: 0.24-0.81) and joint affected (OR = 0.61; 95% CI: 0.42-0.89) were significantly associated with less CSC response. CONCLUSIONS This study highlights the fact that clinical parameters are important in determining CSC response in psoriasis. In daily practice, achieving CSC represents a clinically meaningful treatment goal, especially from the patient perspective.
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Affiliation(s)
- Yuxiong Jiang
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Ying Li
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Dawei Huang
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyuan Zhong
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Qian Yu
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanhua Liang
- Department of Dermatology, Cosmetology and Venereology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Lin Dang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Chengzhi Lv
- Department of Psoriasis, Dalian Dermatosis Hospital, Dalian, China
| | - Binjiang Lin
- Department of Dermatology, Ningbo First Hospital, Zhejiang University, Ningbo, China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yunsheng Liang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Baiyun, Guangzhou, China
| | - Jiajing Lu
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, School of Medicine, Tongji University, Shanghai, China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
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14
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Caldarola G, Chiricozzi A, Megna M, Dapavo P, Giunta A, Burlando M, Malagoli P, Dini V, Mariani M, Fabbrocini G, Quaglino P, Bianchi L, Parodi A, Peris K, De Simone C. Real-life experience with ixekizumab in plaque psoriasis: a multi-center, retrospective, 3-year study. Expert Opin Biol Ther 2023; 23:365-370. [PMID: 36927246 DOI: 10.1080/14712598.2023.2193288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Confirmatory data on the long-term effectiveness and safety of ixekizumab in psoriatic patients from real-world studies are needed. OBJECTIVES The primary aim was to evaluate the 3-year drug survival of ixekizumab in the treatment of patients with moderate-to-severe plaque psoriasis, in a multicenter real-world setting. The secondary aim was to assess the influence of predictive factors on the drug survival of ixekizumab. METHODS A retrospective analysis was performed on a cohort of patients with chronic plaque psoriasis, who received at least one dose of ixekizumab before December 2018. The drug survival analysis was performed and descriptively analyzed using Kaplan-Meier survival curves. Multivariable Cox regression analyses were carried out including variables considered to be of clinical importance. RESULTS A total of 306 patients were enrolled. The overall drug survival at 12, 24, and 36 months of treatment with ixekizumab was 92.11%, 83.85%, and 80.19%, respectively. A higher probability (HR 2.34) of drug withdrawal was found among patients who had already received an anti-IL-17 agent compared with bio-naive patients (p 0.017). CONCLUSIONS We found that ixekizumab is a biological agent characterized by long-term effectiveness, not influenced by several clinical factors and associated with a good safety profile.
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Affiliation(s)
- Giacomo Caldarola
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Chiricozzi
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Megna
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - A Giunta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - M Burlando
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - P Malagoli
- Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - V Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Mariani
- Section of Hygiene, University Department of Health Sciences and Public Health, Rome, Italy
| | - G Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Quaglino
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A Parodi
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - K Peris
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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15
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Jiang C, Zhou H, Zhang W, Xia Y, Li B, Ni X, Wang G, Zhang W, Chen B, He Z, Zhang M, Chen R, Jin H, Deng L. Efficacy, Safety and Pharmacokinetics of IL-17 Monoclonal Antibody Injection (AK111) in Patients with Moderate-to-Severe Plaque Psoriasis: A Randomized, Double-Blinded, Placebo-Controlled Phase Ib Multidose Escalation Clinical Study. Dermatol Ther (Heidelb) 2023; 13:555-567. [PMID: 36566344 PMCID: PMC9884719 DOI: 10.1007/s13555-022-00880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To evaluate the safety, tolerability, immunogenicity, and induced expression of skin biomarkers of AK111 injection after multiple administrations in subjects with moderate-to-severe plaque psoriasis. METHODS This study is a randomized, double-blinded, placebo-parallel-controlled study using a dose escalation mode of multiple doses. A total of 48 subjects were sequentially randomized to receive each AK111 dose regimen (75 mg, 150 mg, 300 mg, 450 mg) or the corresponding placebo. All subjects were treated with the study drug at weeks 0, 1, 4, and 8 and were unblinded at week 12, with the placebo group ending and the AK111 group being followed up to 20 weeks. RESULTS At week 12, compared with placebo, the percentage of subjects achieving Psoriasis Area and Severity Index 75 (PASI75) and static Physician Global Assessment (sPGA) 0/1 in the AK111 75 mg-450 mg dose groups was significantly increased, and higher PASI90 was achieved in the 150 mg, 300 mg, and 450 mg dose groups than in the 75 mg group. All efficacy indicators were maintained at week 20. The incidence of treatment-emergent anti-drug antibodies (ADAs) was 0% (0/48). Neutralizing antibodies (NAbs) were not detected in any subject. The proportion of subjects who reported any treatment-emergent adverse event (TEAE) was 75.0% in the AK111 group, similar to the 66.7% in the placebo group. The most commonly reported adverse events were hyperglycemia, elevated blood pressure, and hypokalemia. The AK111 pharmacokinetics showed approximate dose proportionality with regard to the maximum observed concentration (Cmax) and area under the curve from 0 to the time of the last quantifiable concentration (AUC0-t) following subcutaneous injection doses of 150-450 mg. CONCLUSIONS After moderate-to-severe plaque psoriasis subjects received multiple subcutaneous AK111 injections of 150-450 mg, AK111 exposure increased in a roughly dose-proportional relationship. AK111 was safe and tolerable. In subjects with moderate-to-severe plaque psoriasis, AK111 demonstrated encouraging preliminary efficacy, which was sustained for a relatively long time after the last dose administration. CLINICAL TRIAL REGISTRATION The clinical trial identification number is NCT05504317.
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Affiliation(s)
- Congjun Jiang
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, 613, Huangpu Avenue West, Guanzhou, 510630, Guangdong Province, China
- Department of Dermatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China
| | - Huan Zhou
- National Institute of Clinical Drug Trials, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China
| | - Wanlu Zhang
- Department of Dermatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China
| | - Yu Xia
- Akeso Biopharma, Inc., Zhongshan, China
| | | | - Xiang Ni
- Akeso Biopharma, Inc., Zhongshan, China
| | | | | | | | - Zhimei He
- Akeso Biopharma, Inc., Zhongshan, China
| | - Min Zhang
- Akeso Biopharma, Inc., Zhongshan, China
| | - Rui Chen
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, 41, Damicang Hutong, Beijing, 100032, China.
| | - Hongzhong Jin
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Disease, 15 East Dan Three No, Beijing, 100730, China.
| | - Liehua Deng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, 613, Huangpu Avenue West, Guanzhou, 510630, Guangdong Province, China.
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16
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Gönülal M, Altunay İK, Doğan S, Türkmen M, Balcı DD, Öztürkcan S. Ixekizumab for the treatment of the patients with moderate to severe plaque psoriasis: Clinical data from a real-world experience. Dermatol Ther 2022; 35:e15955. [PMID: 36271759 DOI: 10.1111/dth.15955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022]
Abstract
Real-life data about any particular treatment is very helpful for clinicians, particularly when managing a chronic disease such as psoriasis. In our study, we aimed to reflect our clinical experience during 48 weeks with an IL-17 antagonist ixekizumab. This study was designed as a retrospective multi-center study. Four tertiary referral centers participated into the study. The patients who did not present to the clinics for 3rd month follow-up were excluded. Data including gender, age, weight, type of psoriasis, additional sites on the body, disease duration, previous treatments, duration of medication of ixekizumab, psoriasis area and severity index scores, previous treatments, and comorbidities, the reasons for drug discontinuation, adverse effects and the patients' naïve or non-naïve status were retrieved from electronic patient folders. Although 267 patients met the inclusion criteria, 28 patients were excluded since they did not present to the clinic for 3rd month follow-up so 239 cases were included mmüne research. We determined significant correlations between naive and non-naive cases about getting PASI 75 and PASI 90 responses for all cases (p = 0.005 and p = 0.028, respectively) and between comorbid and non-comorbid cases about getting PASI 90 and PASI 100 responses for all cases (p = 0.021 and p = 0.029, respectively). When we investigate as female and male patients separately, non-comorbid female cases can achieve PASI 100 response significantly easier than comorbid female patients (p = 0.019). Clinicians can use ixekizumab safely mmüne treatment of their patients with psoriasis and get PASI 75-90-100 responses quickly. Ixekizumab is more effective for naive cases but it may also be a treatment option for biologic experienced patients. The ratio of PASI 75-90-100 responses are better in non-comorbid cases than comorbid patients nevertheless ixekizumab is a quite effective agent mmüne treatment of comorbid cases.
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Affiliation(s)
- Melis Gönülal
- Unit of Dermatology, İzmir Tepecik Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - İlknur Kıvanç Altunay
- Unit of Dermatology, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sinan Doğan
- Unit of Dermatology, Çiğli Regional Education Hospital, Bakırçay University, İzmir, Turkey
| | - Meltem Türkmen
- Unit of Dermatology, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Didem Didar Balcı
- Unit of Dermatology, İzmir Tepecik Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Serap Öztürkcan
- Unit of Dermatology, Manisa Celal Bayar University Hafsa Sultan Hospital, Manisa, Turkey
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17
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Outcomes in Ixekizumab Patients Following Exposure to Secukinumab and Other Biologics in the CorEvitas Psoriasis Registry. Dermatol Ther (Heidelb) 2022; 12:2797-2815. [DOI: 10.1007/s13555-022-00834-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
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18
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Ruggiero A, Megna M, Fabbrocini G, Fornaro L, Villani A. Drug safety evaluation of ixekizumab for psoriasis: a review of the current knowledge. Expert Opin Drug Saf 2022; 21:1249-1257. [PMID: 36250261 DOI: 10.1080/14740338.2022.2134855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Since Anti-IL-17s availability, concerns about their safety have been raised due to the inhibition of physiological activities that IL-17A plays in the immune response against infections. Ixekizumab is a humanized monoclonal antibody specifically targeting IL-17A approved for the treatment of moderate-to-severe psoriasis. AREAS COVERED The aim of this review is to evaluate the safety profile of ixekizumab in moderate to severe psoriasis patients. A compressive literature review included article since March 2022. EXPERT OPINION in our analysis, most of the reported AEs were mild or moderate and rarely required treatment discontinuation. Among the class specific AEs to consider during ixekizumab treatment, there are the risk of Candida spp infections and the risk of IBD, which both were reported more frequently than if compared with placebo or other biologics (etanercept, ustekinumab, guselkumab). However, the reported candidiasis resulted mild-to moderate, and easily managed. The risk of IBD (both exacerbation and de novo diagnosis) represents a class effect of IL-17 inhibitors, which should be well evaluated before considering starting ixekizumab treatment. the most common AEs were represented by nasopharyngitis, upper respiratory tract infection, and injection-site reactions. The analysed studies confirmed the favourable safety profile of ixekizumab even in more recently published studies.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Luigi Fornaro
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Alessia Villani
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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19
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Lanna C, Lambiase S, Gaeta Shumak R, Borselli C, Cosio T, Dattola A, Bianchi L, Campione E. Why targeted therapeutics have provided benefit in psoriasis: looking at IL-17 biology. Expert Rev Clin Pharmacol 2022; 15:1209-1224. [PMID: 36189480 DOI: 10.1080/17512433.2022.2130758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Psoriasis is an inflammatory, chronic and immune-mediated disease that can affect the skin and joints. Pro-inflammatory cytokines have a dominant role in the pathogenesis of this heterogeneous disease in which the IL-23/IL-17 axis plays a crucial role. The IL-17 family is involved in numerous processes such as immune defense, intestinal disorders and diseases of the central nervous system. In psoriasis, in particular, many cytokines belonging to the IL-17 family are involved in the inflammatory cascade underlying the disease. AREAS COVERED The knowledge of the mechanisms and pathways behind psoriasis is crucial for the development of new target therapies. We focused on IL-17 biology in order to understand why biological drugs against this cytokine are an effective treatment for moderate to severe psoriasis. Clinical trials results of ixekizumab, brodalumab, secukinumab and bimekizumab have been presented. EXPERT OPINION Il-17 inhibitors are a very fast and effective treatment against psoriasis; however, fungal infections can occur during their use, due to IL-17 biological functions. Therefore, it should be mandatory to choose the right patients to treat with these monoclonal antibodies in order to have a tailored target therapy for each patient.
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Affiliation(s)
- Caterina Lanna
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
| | - Sara Lambiase
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
| | | | | | - Terenzio Cosio
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
| | | | - Luca Bianchi
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
| | - Elena Campione
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
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Jarocki M, Karska J, Kowalski S, Kiełb P, Nowak Ł, Krajewski W, Saczko J, Kulbacka J, Szydełko T, Małkiewicz B. Interleukin 17 and Its Involvement in Renal Cell Carcinoma. J Clin Med 2022; 11:jcm11174973. [PMID: 36078902 PMCID: PMC9457171 DOI: 10.3390/jcm11174973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022] Open
Abstract
Nowadays, molecular and immunological research is essential for the better understanding of tumor cells pathophysiology. The increasing number of neoplasms has been taken under ‘the molecular magnifying glass’ and, therefore, it is possible to discover complex relationships between the cytophysiology and immune system action. An example could be renal cell carcinoma (RCC) which has deep interactions with immune mediators such as Interleukin 17 (IL-17)—an inflammatory cytokine reacting to tissue damage and external pathogens. RCC is one of the most fatal urological cancers because of its often late diagnosis and poor susceptibility to therapies. IL-17 and its relationship with tumors is extremely complex and constitutes a recent topic for numerous studies. What is worth highlighting is IL-17’s dual character in cancer development—it could be pro- as well as anti-tumorigenic. The aim of this review is to summarize the newest data considering multiple connections between IL-17 and RCC.
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Affiliation(s)
- Michał Jarocki
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Julia Karska
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Szymon Kowalski
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Paweł Kiełb
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Łukasz Nowak
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Wojciech Krajewski
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Jolanta Saczko
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Tomasz Szydełko
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Bartosz Małkiewicz
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
- Correspondence: ; Tel.: +48-506-158-136
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21
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Li Q, Qiao J, Jin H, Chen B, He Z, Wang G, Ni X, Wang M, Xia M, Li B, Chen R, Hu P. Population pharmacokinetic/pharmacodynamic analysis of AK111, an IL-17A monoclonal antibody, in subjects with moderate-to-severe plaque psoriasis. Front Pharmacol 2022; 13:966176. [PMID: 36052126 PMCID: PMC9424636 DOI: 10.3389/fphar.2022.966176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
AK111 is an innovative IL-17A antibody, presenting high affinity to IL-17A and showing similar pharmacokinetic (PK) characteristics to those of typical immunoglobulin (Ig) G1 antibodies. To optimize the dosage regimen for phase 2/3 clinical trials, PK and pharmacodynamics (PD) of AK111 were first characterized in Chinese moderate-to-severe plaque psoriasis patients in a phase 1b study. AK111 PK serum sample and Psoriasis Area and Severity Index (PASI) score data were collected from 48 moderate-to-severe psoriasis patients in this study. Non-linear mixed-effects modeling was used for the population PK/PD analysis. A one-compartment model with a first-order absorption and a first-order elimination best described the PK behavior of AK111. The apparent systemic clearance was 0.182 L/day, and the central volume was 6.65 L. The exposure–response relationship was characterized using an indirect response model. The pharmacological effect of AK111 was described in the form of inhibiting the formation of psoriatic plaque, whereas placebo was quantified in the form of promoting the degradation of psoriatic skin lesions. The maximum effect of drug effect (Imax) and placebo effect (PLBmax) was 1 and 0.429, respectively. The rate constant for psoriatic plaque production (Kin) was 0.474 PASI/day and psoriatic plaque loss (Kout) was 0.024 day−1. The body surface area (BSA) affected by psoriasis was identified as a significant covariate on Kout. The simulation results confirmed that all of the predicted PASI90 response rates at week 12 were higher than 60% at 150 and 300 mg dose levels with different regimens and could reach higher than 80% at week 24. We hope this first PK/PD study of AK111 in Chinese moderate-to-severe plaque psoriasis patients will be of help in the further clinical development of AK111 and provide a reference to the dosage optimization for similar antibodies with a long half-life.
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Affiliation(s)
- Qian Li
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju Qiao
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | | | - Zhimei He
- Akeso Biopharma, Inc, Zhongshan, China
| | | | - Xiang Ni
- Akeso Biopharma, Inc, Zhongshan, China
| | - Max Wang
- Akeso Biopharma, Inc, Zhongshan, China
| | | | | | - Rui Chen
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Rui Chen, ; Pei Hu,
| | - Pei Hu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Rui Chen, ; Pei Hu,
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22
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Megna M, Potestio L, Camela E, Fabbrocini G, Ruggiero A. Ixekizumab and brodalumab indirect comparison in the treatment of moderate to severe psoriasis: results from an Italian single-centre retrospective study in a real-life setting. Dermatol Ther 2022; 35:e15667. [PMID: 35762107 PMCID: PMC9540270 DOI: 10.1111/dth.15667] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/22/2022] [Accepted: 06/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Eleven biologic drugs are currently approved for psoriasis management. Real-life studies are needed to guide clinicians in choosing a tailored-tail therapy. The aim of our retrospective study is to indirectly compare the efficacy and safety of ixekizumab and brodalumab in psoriasis patients. METHODS A single-centre real-life retrospective study was performed enrolling moderate-to-severe psoriatic patients under biologic treatment with ixekizumab or brodalumab. For each patient, clinical and demographic data were collected and the effectiveness and safety of brodalumab and ixekizumab treatment were evaluated at weeks 4, 12 and 24. Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) were used for psoriasis severity. RESULTS A total of 139 patients were included in the study: 98(70.5%) and 41(29.5%) patients received ixekizumab and brodalumab, respectively. Mean PASI and BSA significantly reduced at each follow up for both ixekizumab and brodalumab groups. Even if ixekizumab reached higher rates of PASI90 and PASI100 than brodalumab (PASI90: 43.8%vs39.0% PASI100: 20.4%vs17.1% at week4 and PASI90: 83.6%vs75.6% PASI100: 71.5%vs60.9% at week24), these results were not statistically significant. Adverse events, mainly mild, were registered in 25.5% of ixekizumab and 26.8% of brodalumab group, respectively. Discontinuation rate was higher for brodalumab (17.1%vs9.1%), without statistical significance. CONCLUSION Our study showed comparable efficacy and safety for ixekizumab and brodalumab.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Elisa Camela
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
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23
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Li B, Yang L, Bai F, Tong B, Liu X. Indications and effects of biological agents in the treatment of noninfectious uveitis. Immunotherapy 2022; 14:985-994. [PMID: 35695019 DOI: 10.2217/imt-2021-0303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Noninfectious uveitis is a common blinding eye disease, and an autoimmune response is involved in its pathogenesis. Biological agents have gradually been introduced into the treatment of noninfectious uveitis. The authors reviewed the clinical application and side effects of different biological agents on noninfectious uveitis. Biological agents that target TNF-α are widely used in the clinic. Other biological agents, such as IL-6- and IL-1-neutralizing antibodies, are used in patients who do not respond to TNF inhibitors. The efficacy of IL-17 neutralizing antibodies in noninfectious uveitis is controversial. Biological agents targeting T cells and signaling pathways provide new drug options for treatment of noninfectious uveitis. However, it cannot be ignored that these biological agents have side effects, such as increasing risk of infection.
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Affiliation(s)
- Bowen Li
- Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, P.R. China.,Clinical College, Jilin University, Xinmin Street 70, Changchun, 130000, P.R. China
| | - Li Yang
- Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, P.R. China
| | - Feng Bai
- Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, P.R. China
| | - Bainan Tong
- Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, P.R. China
| | - Xiaoli Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, P.R. China
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24
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Tai J, Han M, Kim TH. Therapeutic Strategies of Biologics in Chronic Rhinosinusitis: Current Options and Future Targets. Int J Mol Sci 2022; 23:ijms23105523. [PMID: 35628333 PMCID: PMC9141505 DOI: 10.3390/ijms23105523] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 12/25/2022] Open
Abstract
Chronic rhinosinusitis is a chronic inflammatory disease of the upper airways, for which treatment options include medical or surgical therapy. However, there are limitations to conservative treatment strategies, such as the relapse of nasal polyps. In this review, we discuss the rising role of biomolecular mechanisms associated with various biologics that have been approved or are undergoing clinical trials to treat chronic rhinosinusitis. We also highlight the potential molecular therapeutic targets for managing and treating chronic rhinosinusitis.
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25
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He F, Long F, Yin Z, Yin Z. Local injection of low‐dose ixekizumab for the treatment of palmoplantar pustular psoriasis. Int J Dermatol 2022; 61:742-743. [PMID: 35347721 DOI: 10.1111/ijd.16185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/10/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Fang He
- Department of Dermatology First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - FangYuan Long
- Department of Dermatology First Affiliated Hospital of Nanjing Medical University Nanjing China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Institute of Dermatology Chinese Academy of Medical Sciences & Peking Union Medical College Nanjing China
| | - Zhi Yin
- Department of Dermatology First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - ZhiQiang Yin
- Department of Dermatology First Affiliated Hospital of Nanjing Medical University Nanjing China
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26
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Muench DE, Sun Z, Sharma A, Tang C, Crampton JS, Lao C, Kersjes K, Chang W, Na S. A Pathogenic Th17/CD38 + Macrophage Feedback Loop Drives Inflammatory Arthritis through TNF-α. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 208:1315-1328. [PMID: 35197330 DOI: 10.4049/jimmunol.2101025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/04/2022] [Indexed: 12/29/2022]
Abstract
The pathobiology of rheumatoid inflammatory diseases, including rheumatoid arthritis (RA) and psoriatic arthritis, involves the interplay between innate and adaptive immune components and resident synoviocytes. Single-cell analyses of patient samples and relevant mouse models have characterized many cellular subsets in RA. However, the impact of interactions between cell types is not fully understood. In this study, we temporally profiled murine arthritic synovial isolates at the single-cell level to identify perturbations similar to those found in human RA. Notably, murine macrophage subtypes like those found in RA patients were expanded in arthritis and linked to promoting the function of Th17 cells in the joint. In vitro experiments identified a capacity for murine macrophages to maintain the functionality and expansion of Th17 cells. Reciprocally, murine Th17 cell-derived TNF-α induced CD38+ macrophages that enhanced Th17 functionality. Murine synovial CD38+ macrophages were expanded during arthritis, and their depletion or blockade via TNF-α neutralization alleviated disease while reducing IL-17A-producing cells. These findings identify a cellular feedback loop that promotes Th17 cell pathogenicity through TNF-α to drive inflammatory arthritis.
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Affiliation(s)
- David E Muench
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - Zhe Sun
- Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN; and
| | - Anchal Sharma
- Research Information and Digital Solutions, Lilly Research Laboratories, Eli Lilly and Company, New York, NY
| | - Crystal Tang
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - Jordan S Crampton
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - Christopher Lao
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - Kara Kersjes
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - William Chang
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA
| | - Songqing Na
- Immunology Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, San Diego, CA;
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27
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Adherence and Persistence to Biological Drugs for Psoriasis: Systematic Review with Meta-Analysis. J Clin Med 2022; 11:jcm11061506. [PMID: 35329831 PMCID: PMC8953825 DOI: 10.3390/jcm11061506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Despite the large number of biologics currently available for moderate-to-severe psoriasis, poor adherence and persistence to therapy represent the main issues for both the clinical and economic management of psoriasis. However, the data about adherence and persistence to biologics in psoriasis patients are conflicting. Our aim was to produce summary estimates of adherence and persistence to biologics in adult patients with psoriasis. We performed a systematic review and meta-analysis of observational studies, searching two databases (PubMed and Embase). Sixty-two records met the inclusion criteria, and a meta-analysis was conducted on fifty-five studies. Overall, the proportion of adherent and persistent patients to biological therapy was 0.61 (95% confidence interval: 0.48–0.73) and 0.63 (0.57–0.68), respectively. The highest proportions were found for ustekinumab, while the lowest ones were found for etanercept. The proportions of adherence and persistence to biological drugs in psoriasis patients are sub-optimal. Notably, both proportions largely differ between drugs, suggesting that a more rational use of biologics might ensure better management of psoriasis.
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28
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Megna M, Abategiovanni L, Annunziata A, Torta G, Peduto T, Fabbrocini G, Lauro W. Generalized Pustular Psoriasis rapidly and successfully treated with Ixekizumab in a Caucasian patient. Dermatol Ther 2022; 35:e15382. [PMID: 35170168 PMCID: PMC9287034 DOI: 10.1111/dth.15382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Matteo Megna
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Luisa Abategiovanni
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Alberto Annunziata
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Ginevra Torta
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Tiziana Peduto
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Gabriella Fabbrocini
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
| | - Wanda Lauro
- University of Naples Federico II, Section of Dermatology - Department of Clinical Medicine and Surgery
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29
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Romozzi M, Bellavia S, Caldarola G, De Simone C, Luigetti M, Calabresi P, Di Filippo M, Masullo C, Lucchini M. Ixekizumab exposure associated with myelitis: A case report and a literature review. J Neuroimmunol 2021; 361:577726. [PMID: 34628135 DOI: 10.1016/j.jneuroim.2021.577726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022]
Abstract
We describe a case of a 28-year-old man who developed a cervical myelitis while exposed to ixekizumab (IL-17 inhibitor) for psoriatic arthritis. Spinal MRI showed a T2 hyperintense lesion at the C4-C5 level while brain MRI was unspecific. Oligoclonal bands were absent and extensive screening for autoimmunity was negative. Rechallenge with ixekizumab was positive corroborating a relation between drug exposure and the neurological event. To the best of our knowledge, this is the first case of CNS inflammatory adverse event associated with ixekizumab. We also provide a review of case reports of demyelinating disorders associated with the use of biologic drugs for the treatment of psoriasis and psoriatic arthritis.
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Affiliation(s)
- Marina Romozzi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Simone Bellavia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Caldarola
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Clara De Simone
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Di Filippo
- Clinica Neurologica, Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Carlo Masullo
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Lucchini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
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30
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Sharma A, Upadhyay DK, Gupta GD, Narang RK, Rai VK. IL-23/Th17 Axis: A Potential Therapeutic Target of Psoriasis. Curr Drug Res Rev 2021; 14:24-36. [PMID: 34238181 DOI: 10.2174/2589977513666210707114520] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 11/22/2022]
Abstract
Psoriasis is an immune-mediated skin disease that leads to the initiation of abnormal production of inflammatory mediators and keratinocytes hyper-proliferation. Th-1 cell expressing cytokines such as IL-1β and TNF-α have been the important hallmarks in the management of psoriasis. However, investigations carried out in the previous few years underline the involvement of another subset of T helper cells, i.e. Th-17 in psoriasis exacerbation, and hence become the point of focus now. The immunopathogenesis of Th-17 is the result of the IL-23/Th-17 axis. It involves the release of IL-17 and IL-22 in response to the activated NF-kβ dependent activation of IL-23. The function of human Th-17 cells as well as the crucial role of IL-23/Th-17 axis in the exacerbation of psoriasis and treatment have been well explored. Therefore, considering IL-23/Th17 axis as a pertinent therapeutic target in immune driven disorders, extensive investigations are now highlighting the utility of biopharmaceuticals and/or biological agents acting on these targets. Here, we review the IL-23/Th-17 axis based therapeutic targets, different types of active moieties based on their source of availability and most useful USFDA approved Mabs targeting the IL-23/Th17 axis in psoriasis for a better understanding of the future possibilities in this area.
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Affiliation(s)
- Amit Sharma
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab 142001, India
| | | | - Ghanshyam Das Gupta
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Raj Kumar Narang
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Vineet Kumar Rai
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab 142001, India
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31
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From Messengers to Receptors in Psoriasis: The Role of IL-17RA in Disease and Treatment. Int J Mol Sci 2021; 22:ijms22136740. [PMID: 34201664 PMCID: PMC8268646 DOI: 10.3390/ijms22136740] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022] Open
Abstract
The paradigm of psoriasis as a Th17-driven disease has evolved in the last years towards a much deeper knowledge of the complex pathways, mechanisms, cells, and messengers involved, highlighting the crucial role played by the IL-17 family of cytokines. All IL-17 isoforms signal through IL-17R. Five subunits of IL-17R have been described to date, which couple to form a homo- or hetero-receptor complex. Characteristically, IL-17RA is a common subunit in all hetero-receptors. IL-17RA has unique structural—containing a SEFIR/TILL domain—and functional—requiring ACT-1 for signaling—properties, enabling Th17 cells to act as a bridge between innate and adaptive immune cells. In psoriasis, IL-17RA plays a key role in pathogenesis based on: (a) IL-17A, IL-17F, and other IL-17 isoforms are involved in disease development; and (b) IL-17RA is essential for signaling of all IL-17 cytokines but IL-17D, whose receptor has not been identified to date. This article reviews current evidence on the biology and role of the IL-17 family of cytokines and receptors, with focus on IL-17RA, in psoriasis and some related comorbidities, and puts them in context with current and upcoming treatments.
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Lockshin B, Cronin A, Harrison RW, McLean RR, Anatale-Tardiff L, Burge R, Zhu B, Malatestinic WN, Atiya B, Murage MJ, Gallo G, Strober B, Van Voorhees A. Drug survival of ixekizumab, TNF inhibitors, and other IL-17 inhibitors in real-world patients with psoriasis: The Corrona Psoriasis Registry. Dermatol Ther 2021; 34:e14808. [PMID: 33491259 PMCID: PMC8047872 DOI: 10.1111/dth.14808] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
To compare drug survival of ixekizumab to other IL‐17 inhibitors (IL‐17i) and TNF inhibitors (TNFi) among patients with psoriasis (PsO) in a real‐world setting. Participants included adult PsO patients enrolled in the Corrona Psoriasis Registry who initiated ixekizumab, TNFi, or other IL‐17i between 16 March 2016 to 10 August 2019 and completed ≥1 follow‐up visit. Multivariable adjusted hazard ratios (HR) were calculated to estimate the risk for drug discontinuation in the ixekizumab group relative to the other drugs. Among the 1604 drug initiations, 552 initiated ixekizumab, 450 initiated TNFi, and 602 initiated other IL‐17i. Mean age was 51 years, 49% were women, and 52% were obese (BMI > 30). Ixekizumab patients had a higher proportion of patients with PASI >12 at drug initiation (24%) than TNFi (15%) and other IL‐17i (19%). Over a median of 11 months of follow‐up, 723/1604 (45%) drug discontinuations occurred. Persistence of ixekizumab, TNFi, and other IL‐17i at 24‐months were 68%, 33%, and 46%, among biologic‐naïve patients (n = 543), and 46%, 23%, and 36%, for biologic‐experienced patients (n = 1061), respectively. Ixekizumab patients had a 64% lower risk of discontinuation vs TNFi (HR = 0.36; 95% CI 0.27‐0.47) and a 31% lower risk vs other IL‐17i (HR = 0.69, 95% CI 0.55‐0.87) after adjustment for biologic experience and other covariates. HRs were similar when limited to patients with moderate‐to‐severe PsO (BSA > 3, PASI > 3, and IGA > 1, n = 1076) at initiation. In our study of real‐world patients with PsO, initiators of ixekizumab had more prolonged drug survival than both initiators of TNFi and other IL‐17i up to 2 years of follow‐up.
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Affiliation(s)
| | | | | | | | | | - Russel Burge
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Baojin Zhu
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - Bilal Atiya
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - Gaia Gallo
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Bruce Strober
- Yale University, New Haven, Connecticut, USA.,Central Connecticut Dermatology Research, Cromwell, Connecticut, USA
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Valenzuela F, Flores R. Immunogenicity to biological drugs in psoriasis and psoriatic arthritis. Clinics (Sao Paulo) 2021; 76:e3015. [PMID: 34614113 PMCID: PMC8449932 DOI: 10.6061/clinics/2021/e3015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/10/2021] [Indexed: 01/15/2023] Open
Abstract
Monoclonal antibodies or fusion proteins, defined as biological drugs, have modified the natural history of numerous immune-mediated disorders, allowing the development of therapies aimed at blocking the pathophysiological pathways of the disease, providing greater efficacy and safety than conventional treatment strategies. Virtually all therapeutic proteins elicit an immune response, producing anti-drug antibodies (ADAs) against hypervariable regions of immunoglobulins. Immunogenicity against biological drugs can alter their pharmacokinetic and pharmacodynamic properties, thereby reducing the efficacy of these drugs. In more severe cases, ADAs can neutralize the therapeutic effects of the drug or cause serious adverse effects, mainly hypersensitivity reactions. The prevalence of ADAs varies widely depending on the type of test used, occurrence of false-negative results, and non-specific binding to the drug, making it difficult to accurately assess their clinical impact. Concomitant use of immunosuppressors efficiently reduces the immunogenicity in a dose-dependent manner, either by decreasing the frequency of detectable ADAs or by delaying their appearance, thereby enhancing the effectiveness of biological therapies. Among the new therapeutic strategies for the management of psoriasis, biological agents have gained increasing importance in recent years as they interrupt key inflammation pathways involved in the physiopathology of the disease. Reports regarding ADA in new biologics are still scarce, but the most recent evidence tends to show little impact on the clinical response to the drug, even with prolonged treatment. It is therefore essential to standardize laboratory tests to determine the presence and titles of ADAs to establish their administration and management guidelines that allow the determination of the real clinical impact of these drugs.
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Affiliation(s)
- Fernando Valenzuela
- Department of Dermatology, School of Medicine, University of Chile, Santiago-Chile
- Department of Dermatology, Clínica Las Condes, Santiago-Chile
| | - Rodrigo Flores
- Department of Dermatology, School of Medicine, University of Chile, Santiago-Chile
- Corresponding author. E-mail:
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