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依奇珠单抗治疗银屑病:最新进展。

Ixekizumab for the treatment of psoriasis: up-to-date.

机构信息

Skin cancer and Ageing group, Cancer Research UK Manchester Institute, University of Manchester, Manchester, UK.

The department of Dermatology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK.

出版信息

Expert Opin Biol Ther. 2020 Jun;20(6):549-557. doi: 10.1080/14712598.2020.1729736. Epub 2020 Mar 10.

DOI:10.1080/14712598.2020.1729736
PMID:32050819
Abstract

: Ixekizumab (an IL-17A antagonist) is a biologic therapeutic licensed for use in moderate-to-severe plaque psoriasis and psoriatic arthritis. IL-17 antagonists (also including Secukinumab and Brodalumab) represent a new generation of biologic therapy with rapid and high response rates, quickly becoming a crucial part of the psoriasis treatment armamentarium.: In this review, we describe how IL-17A antagonists disrupt inflammatory cascades in psoriasis and summarize results from clinical trials examining the safety and efficacy of ixekizumab against placebo and comparators.: Ixekizumab induces a 75% reduction in psoriasis area severity index (PASI 75) in 89% of patients after 12 weeks and after 1 year, PASI 75 is maintained in 80% of patients. Ixekizumab is superior to both etanercept and ustekinumab, however, further comparator trials are needed to determine superiority between newer agents. Network meta-analysis suggests that ixekizumab is one of the most rapid and efficacious agents for treating psoriasis, but ideally more long-term real-world data are needed to determine the persistence of response. Candida may be commonly encountered during treatment and IL-17 agents should be avoided in patients with inflammatory bowel disease. Overall, ixekizumab represents an efficacious and well-studied therapeutic that can offer biologic-naïve and bio-failure patients durable disease control.

摘要

依奇珠单抗(一种 IL-17A 拮抗剂)是一种生物治疗药物,已获得许可用于治疗中度至重度斑块型银屑病和银屑病关节炎。IL-17 拮抗剂(包括司库奇尤单抗和布罗达单抗)代表了新一代的生物治疗药物,具有快速和高应答率,迅速成为银屑病治疗武器库的重要组成部分。在这篇综述中,我们描述了依奇珠单抗如何破坏银屑病中的炎症级联反应,并总结了临床试验中评估依奇珠单抗相对于安慰剂和对照药物的安全性和疗效的结果。依奇珠单抗可在 12 周后使 89%的患者的银屑病面积严重程度指数(PASI 75)降低 75%,而在 1 年后,80%的患者仍能维持 PASI 75。依奇珠单抗优于依那西普和乌司奴单抗,但需要进一步的比较试验来确定新型药物之间的优越性。网络荟萃分析表明,依奇珠单抗是治疗银屑病最快速和有效的药物之一,但理想情况下,需要更多长期的真实世界数据来确定疗效的持久性。在治疗过程中可能会经常遇到念珠菌,因此应避免在患有炎症性肠病的患者中使用 IL-17 药物。总的来说,依奇珠单抗是一种有效且研究充分的治疗药物,可为生物初治和生物失败的患者提供持久的疾病控制。

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