engleski

Could anti-IL12/23 therapy replace anti-TNF biologics?

Biologic therapies improved dramatically the outcome of psoriatic arthritis and moderate to severe chronic plaque psoriasis. Anti-TNF agents were developed approximately one decade ago by rheumatologists and represent today one of the most effective class of drugs in severe psoriasis resistant to 2 out of 3 "classical" systemic therapy (methotrexate, cyclosporine, PUVA). Recent research studies on psoriasis pathogenesis focused on early steps of the inflammatory cascade: the activation of T cells with a recent described phenotype Th17 and a consequent expression of interleukins 12 and 23. IL12 and IL23 have a common subunit p40 that is the target of a new therapeutic class, fully human monoclonal antibodies anti IL12/23: ustekinumab and ABT-874. Randomized, placebo-controlled clinical trials in patients with moderate to severe chronic plaque psoriasis using ustekinumab or ABT-874, showed PASI 75 achievements at week 12 in 80% and respectively 93 % of patients. Larger studies are ongoing in order to assess the safety profile of this new therapy. As anti-TNF drugs represent an important and effective treatment of psoriatic arthritis and moderate to severe plaque psoriasis, comparative studies are needed in order to assess the advantages, the safety and the place of anti-IL12/23 in the Era of biologic therapy.

moderate to severe plaque psoriasis; anti-interleukins 12/23 therapy

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