Photo Credit: Omar Halawi
April Armstrong, MD, MPH, spoke with Physician’s Weekly about the role of IL-17 and IL-23 inhibitors in treating psoriasis.
At the 2023 Fall Clinical Dermatology Conference, one session focused on the use of IL-17 and IL-23 inhibitors for the treatment of psoriasis. Physician’s Weekly spoke with April Armstrong, MD, MPH, one of the session’s speakers, to learn more about these agents and their role in psoriasis.
PW: What are the differences between IL-17 and IL-23 inhibitors?
April Armstrong, MD: Both IL-17 inhibitors and IL-23 inhibitors are highly effective for psoriasis and are well tolerated by most patients. IL-23 inhibitors are convenient in terms of dosing schedules; they are typically administrated every 8 to 12 weeks and have a very good safety profile. The IL-23 inhibitors also have a good maintenance effect over time.
How do these drugs work to treat psoriasis?
Both IL-23 and IL-17 are elevated in patients with psoriasis, in both the psoriasis plaques themselves and in the blood. These molecules contribute to a cycle of inflammation. By targeting these cytokines in patients with psoriasis, we can normalize the levels in the blood as well as in the skin so that the patients will experience improvement in their signs and symptoms of psoriasis.
How do clinicians determine which agent to use?
The good news is that, for many patients, both IL-17 and IL-23 inhibitors will work great.
The biggest challenge for clinicians is in the small proportion of patients in whom it is difficult to select a therapy to start with. Sometimes it can seem like a trial-and-error situation, but new technologies are being developed that will allow personalized or precision medicine techniques to aid in our decision about which biologics to use.
For some of these tools, a small sample of the skin can be obtained in a painless way. There are also thousands of biomarkers that can be used to determine which biologic may be best for a patient. Future research that utilizes these tools will help us determine which class of agents is indicated on a patient-by-patient basis.
