META-ANALYSIS: Second IL-17 Inhibitor Effective After Failing Initial Psoriasis Treatment

By Adam Hochron

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For patients diagnosed with psoriasis, the course of the disease can result in having to change medications multiple times. A recent systematic review and meta-analysis looked at whether the use of a second interleukin 17 (IL-17) inhibitor is safe and effective. 

There are currently three FDA-approved IL-17 inhibitors for the treatment of psoriasis: secukinumab, ixekizumab, and brodalumab

Researchers conducted a meta-analysis of 14 studies from PubMed and EMBASE databases. Results were published in the Journal of the American Academy of Dermatology

The studies included 655 patients who were treated with an IL-17 inhibitor after previous exposure to an IL-17 inhibitor. 

Results showed 74.6% of patients achieved a 75% reduction in Psoriasis Area Severity Index (95% CI, 63.9-84.0), 69.4% achieved a 90% reduction (95% CI, 53.2-83.4), and 46.4% achieved a 100% reduction (95% CI, 30.5-62.7) after short-term treatment with a second IL-17 inhibitor.

Study limitations included a high number of studies on a single agent--  ixekizumab -- and reliance on retrospective chart reviews, which did not include information about response to previous IL-17 inhibition.  

“Previous treatment with an IL-17 inhibitor does not appear to affect the efficacy of another IL-17 inhibitor in the treatment of psoriasis,” the authors said. “However, further prospective studies are needed.”

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