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Review
. 2020 Oct;92(4):e12946.
doi: 10.1111/sji.12946.

The TNF/IL-23/IL-17 axis-Head-to-head trials comparing different biologics in psoriasis treatment

Lisa Lynn Ten Bergen  1   2 , Aleksandra Petrovic  1 , Anders Krogh Aarebrot  1 , Silke Appel  1
Affiliations
Free article
Review

The TNF/IL-23/IL-17 axis-Head-to-head trials comparing different biologics in psoriasis treatment

Lisa Lynn Ten Bergen et al. Scand J Immunol. 2020 Oct.
Free article

Abstract

Psoriasis is a T cell-mediated disease with autoimmune characteristics modulated by genetic susceptibility along with environmental triggers. Inflammatory pathways marked with excessive production of cytokines IL-12 and IL-23, drive differentiation of pathogenic T cell responses resulting in TNF and IL-17 production. These cytokines are an integral part of the TNF/IL-23/IL-17 axis, which is responsible for maintaining inflammation in psoriatic skin. Our improved understanding of the immunopathogenesis led to the development of biological drugs in the treatment of moderate-to-severe disease. Biologics have revolutionized the management of psoriasis, highlighting the central role of TNF/IL-23/IL-17 axis in the physiopathology of the disease. Still, psoriasis usually requires long-term treatment, aiming to fully remove psoriatic lesions without experiencing adverse events. In this review, we discuss the recent findings of all 27 available head-to-head trials investigating the efficacy and safety of systemic and biologic therapies in moderate-to-severe psoriasis vulgaris, as it is thought to provide more useful knowledge than placebo intervention alone. According to our evaluation, inhibitors that specifically target IL-23 or IL-17 are clinically more beneficial than inhibitors of IL-12/IL-23 and TNF. More informative results might be obtained by comparing these more efficient biological agents to each other. In addition, newer therapies for psoriasis using small-molecule drugs may represent important advances compared to well-established biologics as these are less expensive and orally administered.

Keywords: TNF/IL-23/IL-17 axis; biologics; cytokines; head-to-head trials; psoriasis.

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References

REFERENCES

    1. Langley RGB, Krueger GG, Psoriasis GCEM. Epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(suppl2):ii18-ii23.
    1. Danielsen K, Duvetorp A, Iversen L, et al. Prevalence of psoriasis and psoriatic arthritis and patient perceptions of severity in Sweden, Norway and Denmark: Results from the nordic patient survey of psoriasis and psoriatic arthritis. Acta Derm Venereol. 2019;99(1-2):18-25.
    1. Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;113(2):377-385.
    1. Chandran V, Raychaudhuri SP. Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis. J Autoimmun. 2010;34(3):J314-J321.
    1. Stuart PE, Nair RP, ELinghaus E, et al. Genome-wide association analysis identifies three psoriasis susceptibility loci. Nat Genet. 2010;42(11):1000.

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