Department of Internal Medicine II, University of Innsbruck, Innsbruck, Austria.
German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Arch Dermatol Res. 2019 Jul;311(5):421-424. doi: 10.1007/s00403-019-01907-y. Epub 2019 Mar 16.
IL-17 blockers are among the newer anti-psoriatic treatment options and little is known about the interclass switching. We have thus initiated a multi-center, multi-national, retrospective study to assess the treatment response of patients who were switched from one IL-17 blocker to another. Analysis consisted of data from patients with moderate-to-severe psoriasis who did not respond satisfactorily to one of the available IL-17 blockers (secukinumab, ixekizumab, brodalumab) and were subsequently switched to another drug of this class. After 12 weeks of treatment, patients' PASIs were evaluated. Treatment success was defined as reaching PASI 75 after 12 weeks. Topical treatment was allowed and used in all patients. 26 patients were included (13 male, 13 female) and 29 switches were evaluated. Overall, 29 switches in 21 patients were evaluated. 18 patients changed their therapy from secukinumab to ixekizumab, or in 7 cases to brodalumab. Brodalumab was used in 3 cases after failure of treatment with ixekizumab. Only in one case, non-response of brodalumab resulted in a therapy switch to secukinumab. In 15 (52%) cases, PASI 75 was reached. In 6 (20%) patients, the switch led to a PASI 50 response. No success of treatment was seen among 8 (28%) participants. When patients fail to respond or do not tolerate an IL-17 blocker, switching to another anti-IL-17A/RA is a promising viable option. Larger studies are needed to confirm our results.
IL-17 阻滞剂是新型抗银屑病治疗选择之一,关于其类别间转换的信息知之甚少。因此,我们开展了一项多中心、多国、回顾性研究,以评估从一种 IL-17 阻滞剂转换为另一种药物的患者的治疗反应。分析包括来自中度至重度银屑病患者的数据,这些患者对一种可用的 IL-17 阻滞剂(司库奇尤单抗、依奇珠单抗、布罗达umab)治疗反应不佳,随后转换为该类别的另一种药物。治疗 12 周后,评估患者的 PASI。治疗成功定义为治疗 12 周后达到 PASI75。允许并在所有患者中使用局部治疗。共纳入 26 例患者(男 13 例,女 13 例),共评估了 29 次转换。总体而言,21 例患者中的 29 次转换得到了评估。18 例患者将治疗方案从司库奇尤单抗转换为依奇珠单抗,或 7 例患者转换为布罗达umab。在依奇珠单抗治疗失败后,用布罗达umab治疗了 3 例患者。只有在 1 例患者中,布罗达umab 无反应导致治疗方案转换为司库奇尤单抗。在 15 例(52%)患者中,达到 PASI75。在 6 例(20%)患者中,转换导致 PASI50 反应。8 例(28%)患者未观察到治疗成功。当患者对 IL-17 阻滞剂无反应或不耐受时,转换为另一种抗 IL-17A/RA 是一种有前途的可行选择。需要更大规模的研究来证实我们的结果。