During her session, “IL-17 Blockers: Safety and Efficacy,” presented at the 2022 Fall Clinical Dermatology Conference, Boni E. Elewski, MD, went over the efficacy and safety of some of the IL-17 blockers used to treat psoriasis, psoriatic arthritis, and more.

To start, Dr Elewski shared that she would be focusing on 4 key IL-17 blockers:

• Secukinumab
• Ixekizumab
• Brodalumab
• Bimekizumab

First, she introduced secukinumab, which is one of the IL-17 antagonists recently approved by the US Food and Drug Administration for psoriasis. It works by blocking IL-17A and is quick acting. Dr Elewski showcased a study where patients with plaque psoriasis taking secukinumab reached PASI 50 within 3 weeks following a 300-mg dose. In fact, about 54% of patients taking secukinumab reached PASI 90 by week 12, with 24% reaching PASI 100 in that same time. Additionally, secukinumab was approved for patients aged 6 years and older. Pediatric patients can have the biologic administered by an adult caregiver. She added that recent studies have shown secukinumab may be beneficial in treating hidradenitis suppurativa.

Next, Dr Elewski presented data on ixekizumab, which also blocks IL-17A and was recently approved to treat psoriasis. She shared that ixekizumab is quick acting by showcasing a study where 70.9% of patients with moderate to severe plaque psoriasis reached PASI 90 and another 35.5% reached PASI 100 by week 12 taking ixekizumab. She also highlighted the durability of ixekizumab by presenting a study showing 55% of patients maintaining PASI 100 and another 73% maintaining PASI 90 by week 60 after shifting the biologic administration from every 2 weeks to every 4 weeks. However, the most important piece Dr Elewski wanted to stress was the impact of ixekizumab on pediatric psoriasis. She discussed how pediatric patients 110 pounds or more could have ixekizumab administered at home, but those equal or less than 110 pounds must have it administered by a nurse or doctor. At week 0, the starting dose should begin at two 80-mg injections a day (a total of 160 mg a day); by week 4 and onward, this injection can decrease to one 80-mg dose every 4 weeks.

Dr Elewski continued onto brodalumab, which is an IL-17 receptor that blocks IL-17A, F, A/f, and E. She shared that brodalumab displayed high durability when 63.4% of patients with moderate to severe plaque psoriasis who took the treatment maintained PASI 100 by week 216.

Finally, Dr Elewski concluded with bimekizumab, an IL-17 A/F blocker, which has shown not only a rapid response but also a rapid onset of action, with patients reaching PASI 90 and PASI 100 in all doses at week 12. It also displayed high efficacy, with 68.2% of patients reaching PASI 100 by week 16. She finished by sharing that these 4 biologics were beneficial in treating psoriasis due to their rapid onset and durable response, and their low safety concerns.

Reference
Elewski B. IL-17 blockers: safety and efficacy. Presented at: Fall Clinical Dermatology Conference 2022; October 20–23, 2022; Las Vegas, NV.