Affiliation:
1. Section of Dermatology, Department of Medical Sciences University of Turin Turin Italy
Abstract
AbstractBackgroundMany national guidelines at the European level recommend first‐line therapy based on the anti‐TNF‐alpha adalimumab for treatment of psoriasis and psoriatic arthritis, mainly for economic reasons. Consequently, patients being treated with newer IL‐17 and IL‐23 inhibitors underwent previous unsuccessful first‐line adalimumab‐based therapy.ObjectivesEvaluate the efficacy and safety of IL‐17 and IL‐23 inhibitors after treatment with adalimumab compared to adalimumab‐naive psoriatic patients.MethodsWe retrospectively analysed 1053 psoriatic patients treated with anti‐IL17 and anti‐IL23 agents, which included 68 and 24 adalimumab‐experienced and 399 and 260 bio‐naive patients. Efficacy was assessed with mean PASI, PASI90, PASI100, and <3.ResultsConcerning the achieving of PASI100, PASI90 and PASI < 3 in patients treated with anti‐IL17 agents, no significant differences were observed between adalimumab‐experienced and bio‐naive patients. In patients treated with an anti‐IL‐23 agent, a faster response was observed in bio‐naive patients, with PASI < 3 significantly higher than ADA‐experienced patients at 16 weeks (77% vs. 58% p = 0.048). In a sub‐analysis that evaluated the performance of anti‐IL17 and anti‐IL23 agents in adalimumab‐experienced patients with a history of secondary failure, no significant differences were found. In multivariate analysis of PASI100, only anti‐IL‐17 therapy appeared to have a negative impact at 52 weeks (OR: 0.54 p = 0.04) independently of previous treatment. For PASI90, type of treatment and bio‐naïve status did not seem to have an impact at any time point.ConclusionsAnti‐IL 23 and anti‐IL 17 agents are not significantly different in terms of efficacy in bio‐naive patients or as second‐line therapy after failure with a biosimilar or originator adalimumab.
Subject
Infectious Diseases,Dermatology
Cited by
8 articles.
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1. Multi‐failure psoriasis patients: characterization of the patients and response to biological therapy in a multicenter Italian cohort;International Journal of Dermatology;2024-01-05
2. Drug survival und klinische Wirksamkeit von Secukinumab, Ixekizumab, Brodalumab, Guselkumab, Risankizumab und Tildrakizumab in der Behandlung der Psoriasis;JDDG: Journal der Deutschen Dermatologischen Gesellschaft;2024-01
3. Interclass Switch between IL17 and IL23 Inhibitors in Psoriasis: A Real-Life, Long-Term, Single-Center Experience;Journal of Clinical Medicine;2023-12-05
4. Is anti‐IL‐17 faster and anti‐IL‐23 better for psoriasis patients after adalimumab failure?;JEADV Clinical Practice;2023-11-06
5. Drug survival and clinical effectiveness of secukinumab, ixekizumab, brodalumab, guselkumab, risankizumab, tildrakizumab for psoriasis treatment;JDDG: Journal der Deutschen Dermatologischen Gesellschaft;2023-11-05