A group of researchers wants clinicians to pay more attention to the adverse events (AE) associated with IL-17 inhibitors in people with psoriasis and psoriatic arthritis (PsA).
Co-authors of a recent scoping review, published in , found that anti-IL-17 agents posed a significant risk of AEs, especially as their use continues to increase.
The systematic review included 57 studies involving 28,424 patients with psoriasis who were treated with anti-IL-17 agents. The anti-IL-17A and anti-IL-17A/F agents had essentially the same incidence of AEs, at 73.45% and 73.12%, respectively. Both were more likely to cause AEs than anti-IL-17R agents (65.66%).
Overall, infection (33.16%), nasopharyngitis (13.74%), and injection site reactions (8.28%) were the most common AEs. IL-17A/F inhibitors most frequently induced diarrhea and abdominal pain, both of which occurred in 25% of patients. The most frequent AE induced by IL-17R agents was viral upper respiratory tract infection, with an incidence as high as 33.65%. Moreover, some data found that long-term use of IL-17 inhibitors revealed a potential to cause mental disorders.
The review was conducted by a team of researchers based in China. The following study excerpts have been edited for length and clarity.
What was the specific impetus for this review?
IL-17 blockers have benefited many patients with moderate-to-severe psoriasis. Compared with traditional therapies, biologics have a high curative effect and are convenient to use.
Currently, there is no summary of the safety of IL-17 agents. To improve their clinical use, study authors analyzed safety data comprehensively. The purpose of the analysis was to evaluate the incidence of AEs caused by IL-17 inhibitors, ultimately to help inform decision-making regarding use of these agents in people with psoriasis and PsA.
What were the review's key conclusions?
The rate of AEs in people who received IL-17 inhibitors for longer than 1 year rose to as high as 79%. The main AEs were infection, diarrhea, headache, and back pain.
However, long-term use of IL-17 inhibitors also had the potential to lead to mental disorders. In one study included in the review, brodalumab was linked with occasional suicidal ideation or behavioral events in patients.
What are the clinical implications of these findings?
As the public has become more aware of biologics, their safety needs focus. Also, because psoriasis often presents with comorbidities (such as cardiovascular disease, abnormal lipid metabolism, chronic obstructive pulmonary disease, and inflammatory bowel disease), the safety profile of these agents must be considered not only for psoriasis but for its related conditions.
No study author disclosed any relevant financial relationship with industry.
Primary Source
Frontiers in Immunology
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