Efficacy and safety of IL-17 inhibitors for patients with psoriatic arthritis: a systematic review and meta-analysis.

OBJECTIVE

The efficacy and safety of IL-17 inhibitors for patients with Psoriatic arthritis (PsA) is still a controversial issue.

MATERIALS AND METHODS

We systematically searched MEDLINE, EMBASE and Cochrane for randomized controlled trials that compared IL-17 inhibitors with placebo or TNF inhibitor adalimumab in patients with PsA.

RESULTS

Eleven studies with 5327 patients were included in the meta-analysis. IL-17 inhibitors were effective in achieving response rates of American College of Rheumatology (ACR) 20, ACR50 and ACR70 compared with the control group. The results of subgroup analyses showed that IL-17 inhibitors had significant advantages in increasing the response rates of ACR20, ACR50 and ACR70 over placebo. IL-17 inhibitors did not show advantages in the responses of ACR20 and ACR50, but they were associated with a higher rate of ACR70 when compared with adalimumab. The longer the follow-up time, the higher the response rates of ACR20, ACR50 and ACR70 in IL-17 inhibitors group. IL-17 inhibitors treatment also significantly increased the rates of PASI75 and PASI90 compared with controls. Additionally, IL-17 inhibitors were associated with higher risks of any Candida infections and injection site reactions and with a lower rate of allergic reactions or hypersensitivities compared with the control group.

CONCLUSIONS

This study provided a clear proof of beneficial effects of IL-17 inhibitors in improving joint disease activity in patients with PsA with an acceptable safety profile.