Age affects drug survival rates of interleukin (IL)‐17 and IL‐23 inhibitors in patients with plaque psoriasis: Results from a retrospective, multicentric, multi‐country, cohort study

Article

作者: Balato, Anna ; Dauden, Esteban ; Conrad, Curdin ; Piaserico, Stefano ; Vender, Ron ; Nogueira, Miguel ; Rompoti, Natalia ; Leite, Luiz ; Di Brizzi, Eugenia Veronica ; Romanelli, Marco ; Teixeira, Laetitia ; Coscarella, Giulia ; Lazaridou, Elizabeth ; Prignano, Francesca ; Messina, Francesco ; Nidegger, Alessia ; Chiricozzi, Andrea ; Stratigos, Alexander J. ; Daponte, Athina‐Ioanna ; Peris, Ketty ; Torres, Tiago ; del Alcázar‐Viladomiu, Elena ; Carrascosa, José‐Manuel ; Gisondi, Paolo ; Bruni, Manfredo ; Vilarrasa, Eva ; Hugo, Jan ; Lynde, Charles ; Alessandri‐Bonetti, Mario ; Mufti, Asfandyar ; Puig, Luis ; Ferreira, Paulo ; Bastos, Pedro Mendes ; Yeung, Jensen ; Valerio, Joana ; Gkalpakiotis, Spyridon ; Ricceri, Federica ; Llamas‐Velasco, Mar

Abstract:

Background:

Scarce data related to the drug survival of biologic agents in psoriasis patients aged ≥65 years is available.

Objectives:

To evaluate the drug survival of interleukin (IL)‐23 or the IL‐17 inhibitors approved for the treatment of moderate‐to‐severe psoriasis in elderly patients (aged ≥65 years), compared with younger adult patients (aged <65 years), and to identify clinical predictors that can influence the drug survival.

Methods:

This retrospective multicentric cohort study included adult patients with moderate‐to‐severe psoriasis, dissecting two‐patient subcohorts based on age: elderly versus younger adults. Kaplan–Meier estimator and proportional hazard Cox regression models were used for drug survival analysis.

Results:

We included 4178 patients and 4866 treatment courses; 934 were elderly (1072 treatment courses), and 3244 were younger patients (3794 treatment courses). Drug survival, considering all causes of interruption, was higher in patients aged <65 years than in elderly patients overall (log‐rank p < 0.006). This difference was significant for treatment courses involving IL‐23 inhibitors (p < 0.001) but not for those with IL‐17 inhibitors (p = 0.2). According to both uni‐ and multi‐variable models, elder age was associated with an increased risk of treatment discontinuation (univariable analysis: HR: 1.229, 95% CI 1.062–1.422; p < 0.006; multivariable analysis: HR: 1.199, 95% CI 1.010–1.422; p = 0.0377). Anti‐IL‐23 agents were associated with a reduced likelihood of treatment discontinuation after adjusting for other variables (HR: 0.520, 95% CI 0.368–0.735; p < 0.001). Being previously treated with IL‐17 inhibitors increased the probability of discontinuation.

Conclusions:

Elderly patients with psoriasis have an increased risk of biologic treatment discontinuation compared with younger adult patients, particularly, if being treated with IL‐23 inhibitors. However, in stratified analyses conducted in elderly patients, IL‐23 inhibitors showed higher drug survival rates than IL‐17 inhibitors.

2024-09-27·Cureus Journal of Medical Science

Successful Treatment of Adalimumab-Induced Paradoxical Skin Reactions in Pustulotic Arthro-Osteitis With Guselkumab

Article

作者: Matsumoto, Takuya ; Fujisawa, Yasuhiro ; Yatsuzuka, Kazuki ; Kidani, Teruki ; Murakami, Masamoto

Pustulotic arthro-osteitis (PAO) is a significant comorbidity of palmoplantar pustulosis (PPP), with biologics targeting tumor necrosis factor (TNF)-α, interleukin (IL)-12/23 p40, IL-23 p19, and IL-17 showing clinical benefits for PPP/PAO. However, patients receiving these biological agents frequently experience paradoxical skin reactions (PSRs), particularly with anti-TNF-α treatments. We report a case of PPP/PAO treated with the anti-TNF-α agent adalimumab, which led to the development of PSRs, including psoriasis-like and folliculitis-like rashes, and acute hair loss. Subsequently, treatment was changed to guselkumab, an anti-IL-23 p19 monoclonal antibody, which successfully controlled both PPP/PAO and PSRs. To date, no PSRs associated with anti-IL-23 agents in PAO have been reported. A study from Japan indicates that guselkumab and adalimumab have similar efficacy in treating PAO. Given that anti-IL-23 agents are approved for refractory PPP under the Japanese health insurance system, we recommend their use over adalimumab in PPP/PAO patients to prevent PSRs.

2024-09-01·European Review for Medical and Pharmacological Sciences

Eczematous reactions in patients with plaque psoriasis receiving biological therapy: an observational study.

Article

作者: Gisondi, P ; Megna, M ; Burlando, M ; Giofré, C ; Bernardini, N ; Caldarola, G ; Cozzani, E ; De Simone, C

OBJECTIVE:

The use of biologic agents, mainly tumor necrosis factor (TNF)-α and interleukin (IL)-17A inhibitors, was associated with cutaneous side effects, but the factors associated with eczematous reactions occurring during biologic treatments are not completely known.

PATIENTS AND METHODS:

An observational, retrospective, multicentre Italian study evaluated the clinical features and the management of eczematous eruptions in 54 patients with chronic plaque psoriasis who developed eczema after treatment with biological agents (anti-IL-17 or 23).

RESULTS:

Many of these patients had personal and family history of atopy. Eczematous reactions developed between a few days and 3 years after initiation of the biologic drug. The highest proportion of cases associated with eczematous reactions during biologic treatments was seen in patients on anti-IL-17 agents, including brodalumab. We observed that eczema rapidly remitted without relapse in all patients who switched to anti-IL-23 agents. Among our cases, fast responders to psoriasis therapy seem to have more persistent eczematous reactions.

CONCLUSIONS:

Patients with psoriasis and a history of atopic dermatitis should be treated with an IL-23 inhibitor due to its efficacy in psoriasis and the rarely reported eczematous reaction.

项与 Anti-IL-23 therapy(Band Therapeutics, LLC) 相关的新闻（医药）

2024-06-20

·FiercePharma

AbbVie's rising star Skyrizi nabs key ulcerative colitis FDA approval

With its latest approval, Skyrizi is now approved to treat both of the forms of inflammatory bowel disease. AbbVie’s fast-growing Humira successor Skyrizi is already on a roll with skyrocketing sales. Now, the IL-23 inhibitor is poised to take on an even larger share of Humira’s fading market dominance with a key expansion into ulcerative colitis. On Tuesday, the FDA granted Skyrizi approval to treat adult patents with moderately to severely active ulcerative colitis (UC). The approval adds some 1 million U.S. patients to the drug’s reach and makes Skyrizi the first IL-23 inhibitor cleared to treat both UC and Crohn’s, the two forms of inflammatory bowel disease (IBD). Following a 12-week induction period, patients can dose themselves at home with an on-body injector device “designed with patients in mind," according to AbbVie's press release. The device adheres to the body and delivers the med in about five minutes. Even in a crowded disease area, Skyrizi boasts an edge with prescribers. A Spherix Global Insights poll of 101 gastroenterologists found that doctors are already on board with the med as a UC treatment, with one-third reporting that Skyrizi is a significant advance over existing products. Doctors favor AbbVie’s offering over Johnson & Johnson’s Tremfya and Abivax’s obefazimod, and most are highly familiar with the drug. One gastroenterologist said they prefer Skyrizi because it has “the best efficacy profile among the IL-23 agents.” After its Crohn's approval in 2022, Skyrizi has been a formidable IBD rival to Johnson & Johnson’s blockbuster Stelara. The AbbVie drug has been taking a “significant share” of the J&J med’s sales, AbbVie executives said on an April earnings call. Coupled with its other two approvals in psoriatic arthritis and plaque psoriasis, AbbVie is making strides in its plan to build up Skyrizi—as well as JAK inhibitor Rinvoq—to make up for falling Humira sales. Last year, Skyrizi’s sales reached $7.7 billion, a 50% leap over 2022. The company has long been working on the double threat to buoy its immunology profile as once-king Humira falls to biosimilar competition following its loss of exclusivity in 2023. With the still-rising success of the two drugs, it’s looking like the plan might be coming to fruition even better than AbbVie once hoped. Analysts at GlobalData expect Skyrizi sales to peak in 2030 at $19.7 billion, while Rinvoq should peak at $12.3 billion for a total haul of $32 billion. By the end of the decade, the duo is poised to contribute 42% of AbbVie’s total revenue. “Given their 2030 drug expiries, these drugs are estimated to not only bolster sales for an extended period of time but […] are [also] poised for long-term sales growth, enabling the company to not only financially recover from Humira’s expiry but to also continue its position as a formidable player within the immunology therapy area,” GlobalData pharma analyst Jasper Morley said in the report.