Year in Review - Part 2 - IL-17 for Psoriatic Arthritis

IL-17 inhibitors are coming up next on the horizon for the treament of PsA. IL-17 is an integral player in a complex regulatory network. There are two types of IL-17 called IL-17a and IL-17f. There are currently three molecules in development to inhibit IL-17:

Secukinumab (monoclonal Ab to IL-7)
Ixekizumab (monoclonal Ab to IL-17)
Brodalumab (IL-17RA receptor antibody)

The speaker presented a trial of Brodalumab that was published in the New England Journal of Medicine (Mease PJ et al. NEJM 370(24):2295-2306, 2014). The summary conclusion presented was:

ACR 20 at week 12 (140 mg) 37% and (280 mg) 39% vs. 18% for PBO.
Responses were sustained at 52 weeks, with some attenuation for the higher dose (280 mg).
Similar incidence of serious adverse events.

There are now several categories of medications to treat PsA (DMARDs, TNF inhibitors, PDE4 inhibitors, and IL-17 inhibitors). The big question that still remains is ... are the new therapies better for the skin or for the joints?

More reports from ACR 2014