When IL-17 inhibitors fail: Real-life evidence to switch from secukinumab to adalimumab or ustekinumab

Dermatol Ther. 2019 Mar;32(2):e12793. doi: 10.1111/dth.12793. Epub 2018 Dec 21.

Abstract

Psoriasis is a chronic, systemic inflammatory disease that in the moderate to severe forms may benefit of biologics, namely TNF and IL-12/23 and IL-17 inhibitors. Loss of response, lack of response, or discontinuation due to adverse events represent a concrete therapeutic challenge for dermatologists that have to switch patients to other treatments. Although some evidences already exist toward the switch from IL-12/23 and TNF inhibitors to IL-17 inhibitors, conversely nothing is present toward the switch from IL-17 inhibitors to IL-12/23 and TNF inhibitors. We performed a real-life study enrolling 50 patients randomly switched to adalimuamb, a TNF inhibitor, or ustekinumab, an IL-12/23 inhibitor. Our observational study suggests that switching from IL-17i to TNFi and IL-12/23i is a safe and effective therapeutic strategy.

Keywords: DLQI; PASI; adalimumab; psoriasis; real-life; secukinumab; switching; ustekinumab.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adalimumab / administration & dosage*
  • Adalimumab / pharmacology
  • Adult
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal, Humanized
  • Cohort Studies
  • Dermatologic Agents / administration & dosage
  • Dermatologic Agents / pharmacology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Psoriasis / drug therapy*
  • Psoriasis / pathology
  • Severity of Illness Index
  • Treatment Outcome
  • Ustekinumab / administration & dosage*
  • Ustekinumab / pharmacology

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Dermatologic Agents
  • secukinumab
  • Ustekinumab
  • Adalimumab