Comparison of the Safety and Efficacy of Tumor Necrosis Factor Inhibitors and Interleukin-17 Inhibitors in Patients With Psoriasis
August 2019 | Volume 18 | Issue 8 | Original Article | 776 | Copyright © August 2019
Lawrence J. Green MD,ª Paul S. Yamauchi MD PhD,b Leon H. Kircik MDc
ªGeorge Washington University School of Medicine, Rockville, MD bDavid Geffen School of Medicine at UCLA, Los Angeles, CA cIcahn School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC; DermResearch, PLLC; Skin Sciences, PLLC, Louisville, KY
Psoriasis (PsO) is a common, systemic, chronic inflammatory disease characterized by key clinical symptoms, including itching, pain, and scaling, and is associated with substantial physical, psychosocial, and economic health burdens. Currently, there is no cure for PsO; however, the introduction of biologic therapies has revolutionized the clinical management of patients with PsO by expanding treatment options to include multiple therapies with different mechanisms of action targeting cytokines, including tumor necrosis factor inhibitors (TNFis), interleukin (IL)-17A inhibitors, an IL-12/23 inhibitor, and IL-23 inhibitors. TNFis are historically considered the first-line biologic treatment and the first-generation biologics; however, increased understanding of TNF-α and IL-17 synergistic functions have recently led to evidence that specifically targeting IL-17 may be more likely to improve disease activity than a more general, nonspecific therapy target, such as TNF-α. This review highlights currently available evidence and demonstrates the differences between TNFis and IL-17A inhibitors in patients with PsO with regard to efficacy and safety. J Drugs Dermatol. 2019;18(8):776-788.