Department of Dermatology, The Second Affiliated Hospital of JiLin University, Changchun, China.
Department of Dermatology, The Second Affiliated Hospital of JiLin University, Changchun, China -
Minerva Med. 2020 Jun;111(3):254-265. doi: 10.23736/S0026-4806.20.06460-5. Epub 2020 Mar 12.
With the discovery of the IL-23 / Th17 axis, the treatment of psoriasis has entered a new era. The aim of this study was to explore the progress of biologics and janus kinases (JAK) inhibitors targeting IL-23/Th17 axis in the treatment of psoriasis. review of English-language article was performed. Search terms included IL-17, IL-23, biologics, monoclonal antibodies, neutralizing antibodies, JAK, inhibitors, Psoriasis Area Severity Index and psoriasis. Data were selected from two phase 2 clinical trials; and nine phase 3 randomized, double-blind clinical trials; and other clinical trials. This review analyzes skin lesion clearance and major adverse reactions of 9 mAbs including mirikizumab and bimekizumab. At the same time, the research progress and prospects of three non-IgG small molecule biologics are analyzed too. This paper also compares the efficacy and limitations of biologics targeting the IL-23/Th17 axis with non-biologics acting on the JAK-signal transducer and activator of transcription pathway. The IL-17A/F inhibitors and non-IgG small molecule biologics that are being studied will bring a revolutionary development to the treatment of psoriasis. Topical application of JAK inhibitors can not only achieve the purpose of treating psoriasis, but also reduce the amounts of systemic medication, and reduces side effects. Each drug has its own indication, and the effect of the drug can be better achieved by selecting the indication for the drug.
随着 IL-23/Th17 轴的发现，银屑病的治疗进入了一个新时代。本研究旨在探讨靶向 IL-23/Th17 轴的生物制剂和 Janus 激酶（JAK）抑制剂在银屑病治疗中的进展。对英文文章进行了综述。检索词包括 IL-17、IL-23、生物制剂、单克隆抗体、中和抗体、JAK、抑制剂、银屑病面积严重指数和银屑病。数据选自两项 2 期临床试验；9 项 3 期随机、双盲临床试验；和其他临床试验。本综述分析了包括 mirikizumab 和 bimekizumab 在内的 9 种 mAb 的皮损清除和主要不良反应。同时，还分析了三种非 IgG 小分子生物制剂的研究进展和前景。本文还比较了靶向 IL-23/Th17 轴的生物制剂与作用于 JAK-信号转导和转录激活剂通路的非生物制剂的疗效和局限性。正在研究的 IL-17A/F 抑制剂和非 IgG 小分子生物制剂将给银屑病治疗带来革命性的发展。局部应用 JAK 抑制剂不仅可以达到治疗银屑病的目的，还可以减少全身用药的剂量，降低副作用。每种药物都有其自身的适应证，通过选择药物的适应证，可以更好地发挥药物的疗效。
