Anti‐IL‐23 and Anti‐IL‐17 Biologic Agents for the Treatment of Immune‐Mediated Inflammatory Conditions

Abstract

Advancements in the immunopathogenesis of psoriasis have identified interleukin (IL)-23 and IL-17 as fundamental contributors in the immune pathways of the disease. Leveraging these promising therapeutic targets has led to the emergence of a number of anti-IL-23 and -17 biologic agents with the potential to treat multiple conditions with common underlying pathology. The unprecedented clinical efficacy of these agents in the treatment of psoriasis has paved way for their evaluation in diseases such as psoriatic arthritis, Crohn's disease, rheumatoid arthritis, in addition to other immune-mediated conditions. Here we review the IL-23/IL-17 immune pathways and discuss the key clinical and safety data of the anti-IL-23 and anti-IL-17 biologic agents in psoriasis and other immune-mediated diseases.A number of immune-mediated diseases, while being clinically distinct, do share similar underlying pathophysiologic processes driven by a common subset of central molecules; this offers the valuable opportunity to treat a number of these important conditions through a few specific mutual therapeutic targets. The recent discovery of the critical roles of interleukin (IL)-23 and IL-17 in the pathogenesis of psoriasis plus numerous other immune-mediated diseases has made these two cytokines key therapeutic targets for newly developed biologic agents. This review provides a brief discussion of the IL-23/IL-17 immune axis, and will present key clinical and safety data of the anti-IL-23 and anti-IL-17 biologic agents in the treatment of common immune-mediated inflammatory conditions. THE IL-23/IL-17 IMMUNE AXISThrough the excellent research over the last decade by immunopathologists (James Krueger and Frank Nestle), the spectrum of immune mediators (cytokines) in psoriasis and other immunemediated conditions has improved significantly. IL-23 plays a central role in T-cell-mediated responses and has been deemed a key promoter of immune-mediated conditions. Sharing a common p40 subunit with IL-12 and a unique p19 subunit, the IL-23 heterodimer promotes signaling through both the IL-23 receptor (IL-23R) and IL-12Rb1 subunit of the IL-12 receptor (IL-12R) (Figure 1

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