Current Evidence for IL-17/23 Blockade for the Treatment of Lupus Nephritis

Abstract

In the current medical literature, there is increasing evidence for the involvement of the interleukin (IL)-17/23 axis and the potential role of Th17 cells in the pathogenesis of lupus nephritis. Knowledge about the interaction of these immunological pathways in the development of autoimmune diseases has led to the identification of new therapeutic strategies aimed at blocking them. For this reason, the main objective of this review focuses on knowing the recent evidence of the different anti-IL-17/23 treatment strategies in lupus nephritis and their future perspectives. A non-systematic narrative review of the literature was carried out following the objective of having the most representative information on the different anti-IL-17/23 drugs available together with the description of the pathophysiological mechanisms of this pathway involved in systemic lupus erythematosus and lupus nephritis. Despite the great existing theoretical foundation, today few clinical studies support the use of these therapies in both contexts. Nevertheless, the publication of research with a better methodology is expected to approve the indication of some of these drugs in lupus nephritis. However, the clinical response seen with ustekinumab and secukinumab in clinical studies and case reports published to date has been encouraging.

Significance of Interleukin 23 in Systemic Lupus Patients: Relation to Disease Activity and Damage Indices

“…Hence, antagonists of these cytokines have been tried as novel therapies for SLE, especially LN, with some promising results. 28–34 Ustekinumab and Secukinumab were found to be effective in SLE treatment and gave a good response in comparison to placebo in a study done by Santacruz et al 35 Brodalumab and Ixekizumab do not have ongoing clinical studies to our knowledge.…”