Frieder Jillian, Kivelevitch Dario, Menter Alan
Baylor Scott and White- Division of Dermatology, Dallas, TX, USA.
Baylor Scott and White- Division of Dermatology, 3900 Junius Street, Suite 125, Dallas, TX 75246, USA.
Ther Adv Chronic Dis. 2018 Jan;9(1):5-21. doi: 10.1177/2040622317738910. Epub 2017 Nov 16.
Psoriasis is a systemic inflammatory disease associated with numerous comorbidities and a profound impact on patients' quality of life. While its complex immune pathogenesis is still not fully delineated, current evidence supports a fundamental role of the T-helper-17 (TH-17) pathway and its related interleukin-17 (IL-17) cytokine. Thus, new antipsoriatic therapies have been developed to block this key cytokine and its downstream effects. Secukinumab is a fully humanized, monoclonal anti-IL-17A antibody, and the first in its class to be approved by the US Food and Drug Administration for the treatment of moderate to severe plaque psoriasis. It has also been approved for the treatment of active psoriatic arthritis and ankylosing spondylitis. Its clinical efficacy in plaque psoriasis has been well demonstrated in numerous phase II and III clinical trials. In addition, it has shown superiority in clinical trials to current biologic agents including etanercept and ustekinumab, with a safe adverse event profile. In correlation with excellent skin improvements, secukinumab is also associated with significant improvements in health-related quality of life measures. Thus, secukinumab offers the potential for equal, or improved, therapeutic effects compared with other biologics, and is a valuable addition to our current antipsoriatic armamentarium.
银屑病是一种全身性炎症性疾病,与多种合并症相关,对患者的生活质量有深远影响。虽然其复杂的免疫发病机制仍未完全阐明,但目前的证据支持辅助性T细胞17(TH - 17)途径及其相关的白细胞介素 - 17(IL - 17)细胞因子的关键作用。因此,已开发出新的抗银屑病疗法来阻断这种关键细胞因子及其下游效应。司库奇尤单抗是一种完全人源化的单克隆抗IL - 17A抗体,是该类药物中首个被美国食品药品监督管理局批准用于治疗中度至重度斑块状银屑病的药物。它也已被批准用于治疗活动性银屑病关节炎和强直性脊柱炎。其在斑块状银屑病中的临床疗效已在众多II期和III期临床试验中得到充分证明。此外,在临床试验中,它已显示出优于包括依那西普和乌司奴单抗在内的现有生物制剂,且不良事件谱安全。与出色的皮肤改善情况相关联,司库奇尤单抗还与健康相关生活质量指标的显著改善有关。因此,与其他生物制剂相比,司库奇尤单抗具有产生同等或更好治疗效果的潜力,是我们目前抗银屑病药物库中的一个有价值的补充。