Anti-IL17 therapies for psoriasis

How can we manage the safety concerns associated with the increase in biologics for psoriasis?

“…Most patients showed complete resolution after antifungal treatment. Rates of serious infections for all IL-17 agents are comparable to placebo [13,14].…”

“…The most common AEs reported in clinical trials for the IL-17 inhibitors include: nasopharyngitis, diarrhea, URIs, headache, arthralgias, mild transient neutropenia, and ISRs [9]. Infrequent cases of hepatotoxicity with these agents have also been observed [9,14,15].…”

“…Another concern with IL-17 inhibitors, specifically in patients with a personal or family history of inflammatory bowel disease (IBD), is the 0.1-0.2% potential for activation or exacerbation of IBD [8,14]. Both psoriasis and IBD exhibit shared immunological pathways and overlapping genetic profiles, with studies showing an increased prevalence of IBD in patients with psoriasis [2].…”

“…Although a direct causal relationship has not been established between IL-17 agents and IBD, appropriate screening and caution is recommended when considering IL-17 agents in patients with a history of IBD. Alternative treatment options should be considered in patients with a definitive IBD diagnosis [13,14].…”

HIV‐associated psoriasis: Epidemiology, pathogenesis, and management

“…Agents acting against IL‐17A, such as secukinumab, ixekizumab, and brodalumab, have been recently approved for the treatment of moderate and severe psoriasis (Silfavast‐Kaiser, Paek, & Menter, ). However, there are still no evidences about their safety and effectiveness in PLWH.…”