The IL-23/IL-17A axis in spondyloarthritis: therapeutics informing pathogenesis?
Anti-Inflammatory Agents
/ immunology
Arthritis, Psoriatic
/ drug therapy
Biomarkers
/ analysis
Humans
Immunity
/ immunology
Inflammatory Bowel Diseases
/ drug therapy
Interleukin-17
/ antagonists & inhibitors
Interleukin-23
/ antagonists & inhibitors
Psoriasis
/ drug therapy
Signal Transduction
/ drug effects
Spondylarthritis
/ drug therapy
Uveitis
/ drug therapy
Journal
Current opinion in rheumatology
ISSN: 1531-6963
Titre abrégé: Curr Opin Rheumatol
Pays: United States
ID NLM: 9000851
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
pubmed:
16
5
2020
medline:
27
4
2021
entrez:
16
5
2020
Statut:
ppublish
Résumé
To give an overview of the recently published trials relating to IL-23/IL-17 pathway in spondyloarthritis (SpA). Recent studies in psoriasis confirmed the efficacy of targeting the IL-23/IL-17 pathway, with emerging evidence from head-to-head studies suggesting functional hierarchy of these inhibitors. In psoriatic arthritis (PsA), recent studies have indicated the efficacy of inhibiting IL-23p19, in addition to IL-23p40 and IL-17A, albeit all with lower hurdle results than those seen in psoriasis. The first head-to-head study of an IL-17A and tumour necrosis factor inhibitor in PsA has also recently been published. Recent studies have demonstrated the efficacy of the IL-17A inhibitor, ixekizumab, across the axial SpA spectrum. In contrast, inhibition of IL-12/IL-23p40 and IL-23p19 both failed in axial SpA. In inflammatory bowel disease (IBD), recent studies indicate efficacy of IL-23p40 and IL-23p19 inhibition, in contrast to the previous failed studies of IL-17 inhibition. Clinical trials of IL-23/IL-17 inhibition have been transformative in psoriasis, with more mixed results in PsA and differential responses in axial SpA and IBD. These results pose challenges to our fundamental understanding of SpA pathogenesis and further head-to-head studies and more subtle evaluation of the local tissue-specific aspects will be required.
Identifiants
pubmed: 32412997
doi: 10.1097/BOR.0000000000000719
pii: 00002281-202007000-00005
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Biomarkers
0
IL17A protein, human
0
Interleukin-17
0
Interleukin-23
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
349-356Références
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