The IL-17 cytokine family encompasses six different homodimers and heterodimers referred to as IL-17A-F. Due to some differences in the mechanism of IL-17 inhibition, aninsufficient effect of one IL-17 inhibitor does not necessarily imply lack of efficacy of the other agent of the same class. Aim of study was analysis of the success rate of switches among IL-17 inhibitors (secukinumab, ixekizumab, and brodalumab) in patients treated in the Czech Republic. Data were obtained from the Czech nationwide registry of psoriatic patients receiving biological/targeted therapy (BIOREP). Our analysis involved data of a total of 90 patients with severe chronic plaque psoriasis and baseline PASI scores >10 both prior to first-line biological therapy initiation and after switch to another agent of the class of IL-17 inhibitors. The most effective switch was that from secukinumab to brodalumab, with PASI 90 reached by 64.7% and 73.3% of patients at weeks 12 and 24. Among patients switched from secukinumab to ixekizumab target PASI 90 responses were achieved (at weeks 12 and 24) by 41.2% and 55.2% of patients. Among patients switched from ixekizumab to brodalumab target PASI 90 responses were achieved, at the above time points, by 30.8% and 38.5% of patients. Our analysis showed a high success rate of switches from secukinumab to ixekizumab and brodalumab, followed by the ixekizumab-to-brodalumab switch. Importantly, the therapeutic response and success rates of individual switches are independent of the patient's body weight and presence of psoriatis arthritis.

Department of Dermatology and Venereology Faculty of Medicine and Dentistry Palacky University and University Hospital Olomouc Olomouc Czech Republic

Department of Dermatovenereology 1st Faculty of Medicine and General University Hospital Charles University Prague Czech Republic

Department of Dermatovenereology 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital Prague Czech Republic

Department of Dermatovenereology Faculty of Medicine in Pilsen Charles University Prague Czech Republic

Value Outcomes Prague Czech Republic

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Damiani G, Bragazzi NL, Karimkhani Aksut C, et al. The global, Regional, and National Burden of psoriasis: results and insights from the Global Burden of Disease 2019 study. Front Med (Lausanne). 2021;8:743180.

Hawkes JE, Yan BY, Chan TC, Krueger JG. Discovery of the IL-23/IL-17 signaling pathway and the treatment of psoriasis. J Immunol. 2018;201:1605-1613.

Tollenaere MAX, Hebsgaard J, Ewald DA, et al. Signaling of multiple interleukin (IL)-17 family cytokines via IL-17 receptor A drives psoriasis-related inflammatory pathways. Br J Dermatol. 2021;185(3):585-594.

Blauvelt A, Chiricozzi A. The immunologic role of IL-17 in psoriasis and psoriatic arthritis pathogenesis. Clin Rev Allergy Immunol. 2018;55(3):379-390.

Johansen C, Usher PA, Kjellerup RB, Lundsgaard D, Iversen L, Kragballe K. Characterization of the interleukin-17 isoforms and receptors in lesional psoriatic skin. Br J Dermatol. 2009;160:319-324.

Gassliter I, Kirsten N, Augustin M, et al. Successful intra-class switching among IL-17 antagonists: a multicentre, multinational, retrospective study. Arch Dermatol Res. 2019;311:421-424.

Goepfert A, Lehmann S, Blank J, Kolbinger F, Rondeau JM. Structural analysis reveals that the cytokine IL-17F forms a homodimeric complex with receptor IL-17C to drive IL-17RA-independent signaling. Immunity. 2020;52:499-512.

Kimmel G, Chima M, Kim HJ, et al. Brodalumab in the treatment of moderate to severe psoriasis in patients when previous anti-interleukin 17A therapies have failed. J Am Acad Dermatol. 2019;81:857-859.

Berman J, Furer V, Berman M, et al. Treatment with ixekizumab following secukinumab failure in patients with psoriatic arthritis: real-life experience from a resistant population. Biol Theory. 2021;15:463-470.

Bokor-Billmann T, Schäkel K. No need to change the drug class: ixekizumab-following secukinumab-therapy in psoriasis. J Dermatol Treat. 2019;30(3):216-220.

Sherman S, Solomon-Cohen E, Amitay-Laish I, Hodak E, Pavlovsky L. IL-17A inhibitor switching-efficacy of Ixekizumab following Secukinumab failure: a single-Center experience. Acta Derm Venereol. 2019;99:769-773.

Damiani G, Conic RRZ, de Vita V, et al. When IL-17 inhibitors fail: real-life evidence to switch from secukinumab to adalimumab or ustekinumab. Dermatol Ther. 2019;32(2):e12793.

Damiani G, Conic RRZ, Pigatto PDM, et al. Predicting secukinumab fast-responder profile in psoriatic patients: advanced application of artificial-neural-networks (ANNs). J Drugs Dermatol. 2020;19(12):1241-1246.

Thaci D, Blauvelt A, Reich K, et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. J Am Acad Dermatol. 2015;73:400-409.

Griffiths CE, Reich K, Lebwohl M, et al. UNCOVER-2 and UNCOVER-3 investigators. Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet. 2015;386:541-551.

Paul C, Griffiths CEM, van de Kerkhof PCM, et al. Ixekizumab provides superior efficacy compared with ustekinumab over 52 weeks of treatment: results from IXORA-S, a phase 3 study. J Am Acad Dermatol. 2019;80:70-79.e3.

Doshi JA, Takeshita J, Pinto L, et al. Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population. J Am Acad Dermatol. 2016;74:1057-1065.

Elmets CA, Leonardi CL, Davis DMR, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dematol. 2019;80(4):1073-1113.

Torres T, Puig L, Vender R, et al. Drug survival of IL-12/23, IL-17 and IL-23 inhibitors for psoriasis treatment: a retrospective multi-country, multicentric cohort study. Am J Clin Dermatol. 2021;22(4):567-579.

Florek AG, Wang CJ, Armstrong AW. Treatment preferences and treatment satisfaction among psoriasis patients: a systematic review. Arch Dermatol Res. 2018;310(4):271-319.

Facheris P, Valenti M, Pavia G, et al. Brodalumab: a new way to inhibit IL-17 in psoriasis. Dermatol Ther. 2020;33(3):e13403.

Mease PJ, Helliwell PS, Hjuler KF, Raymond K, McInnes I. Brodalumab in psoriatic arthritis: results from the randomised phase III AMVISION-1 and AMVISION-2 trials. Ann Rheum Dis. 2020;0:1-9.

Damiani G, Cazzaniga S, Conic RRZ, Naldi L. Psoracare registry network. Pruritus characteristics in a large Italian cohort of psoriatic patients. J Eur Acad Dermatol. 2019;33(7):1316-1324.