Anti-IL17 treatment in childhood chronic rheumatic diseases

Abstract

Introduction: Interleukin-17 (IL-17) is a family of cytokines that plays a key role in several rheumatic diseases in both adults and children. In the last few years, several drugs targeting IL-17 have been developed.

Areas covered: We present a review on the current state of the art regarding the use of anti-IL17 in childhood chronic rheumatic diseases. To date, the available evidence is limited and mainly focuses on juvenile idiopathic arthritis (JIA) and a specific autoinflammatory disease called deficiency of IL-36 receptor antagonist (DITRA). Recently, a randomized controlled trial resulted in the approval of secukinumab (an anti-IL17 monoclonal antibody) for JIA, due to its demonstrated efficacy and safety. Promising and potential uses of anti-IL17 in Behçet's syndrome and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome have also been described.

Expert opinion: Increasing knowledge about the pathogenetic mechanisms underlying rheumatic diseases is leading to an improvement in the care of several chronic autoimmune diseases. In this scenario, anti-IL17 therapies (such as secukinumab and ixekizumab) might be an optimal choice. Recent data on the use of secukinumab in juvenile spondyloarthropathies can be a starting point for future treatment strategies in other pediatric rheumatic diseases, such as Behçet's syndrome and the chronic non-bacterial osteomyelitis disease spectrum, particularly SAPHO syndrome.

Keywords: Behçet’s syndrome; IL17 inhibitors; SAPHO syndrome; biologic therapy; children; ixekizumab; juvenile idiopathic arthritis; noninfectious uveitis; secukinumab.