Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
Background. The role of interleukin-12 (IL-12), interleukin-23 (IL-23), and interleukin-17 (IL-17) has been recognized in psoriasis pathogenesis, and new drugs targeting this axis have already been developed which may provide a new therapeutic approach for patients with moderate to severe psoriasis....
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2019/2546161 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850237407966789632 |
|---|---|
| author | Fan Bai Gang Gang Li Qingmin Liu Xinwu Niu Ruilian Li Huiqun Ma |
| author_facet | Fan Bai Gang Gang Li Qingmin Liu Xinwu Niu Ruilian Li Huiqun Ma |
| author_sort | Fan Bai |
| collection | DOAJ |
| description | Background. The role of interleukin-12 (IL-12), interleukin-23 (IL-23), and interleukin-17 (IL-17) has been recognized in psoriasis pathogenesis, and new drugs targeting this axis have already been developed which may provide a new therapeutic approach for patients with moderate to severe psoriasis. Objective. To compare the direct and indirect evidences of the efficacy and safety of brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab in the short-term treatment of moderate to severe plaque psoriasis using network meta-analysis (NMA). Methods. A comprehensive literature search was performed in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for the available relevant studies. NMA was conducted by Stata 15.0 software using relative risks (RR) with 95% confidence interval to assess the clinical effectiveness and safety. Ranked the efficacy and safety for each drug accordance with the surface under the cumulative ranking curve (SUCRA). Results. This meta-analysis included 28 studies. All the interventions performed better than placebo in short-term achievement. Based on the result of SUCRA, ixekizumab 80 mg every 2 weeks ranked the highest in short-term achievement of PASI 75 (SUCRA = 93.0%). Brodalumab 210 mg ranked the highest in short-term achievement of PASI 100 (SUCRA = 85.0%). Secukinumab 300 mg ranked the highest in short-term achievement of sPGA 0/1 or IGA 0/1 or PGA 0/1 (SUCRA = 98.1%). In terms of having a risk of adverse events, the rates were higher in brodalumab, secukinumab, ixekizumab, and ustekinumab 45 mg compared with placebo. Ixekizumab 80 mg every 4 weeks ranked the highest in the risk of adverse events during short-term treatment (SUCRA = 4.5%). Guselkumab 50 mg ranked the highest in the risk of serious adverse events during short-term treatment (SUCRA = 25.9%). Ixekizumab 80 mg every 4 weeks ranked the highest in the risk of discontinuations due to adverse events during short-ter treatment (SUCRA = 10.7%). Conclusions. IL-17, IL-12/23, and IL-23 inhibitors had high efficacy in the achievement of PASI 75, PASI 100, and sPGA 0/1 or IGA 0/1 or PGA 0/1 in moderate to severe plaque psoriasis after 12 or 16 weeks of treatment. IL-17 inhibitors showed superior efficacy. However, its clinical safety was poor. Risankizumab appeared to have relatively high efficacy and low risk. The clinical tolerance of other biological agents needs to be further observed. |
| format | Article |
| id | doaj-art-1c90a7bca07a41a2b0f8f2bc1511edc5 |
| institution | OA Journals |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-1c90a7bca07a41a2b0f8f2bc1511edc52025-08-20T02:01:45ZengWileyJournal of Immunology Research2314-88612314-71562019-01-01201910.1155/2019/25461612546161Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled TrialsFan Bai0Gang Gang Li1Qingmin Liu2Xinwu Niu3Ruilian Li4Huiqun Ma5The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaThe Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaThe Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaThe Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaThe Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaThe Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaBackground. The role of interleukin-12 (IL-12), interleukin-23 (IL-23), and interleukin-17 (IL-17) has been recognized in psoriasis pathogenesis, and new drugs targeting this axis have already been developed which may provide a new therapeutic approach for patients with moderate to severe psoriasis. Objective. To compare the direct and indirect evidences of the efficacy and safety of brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab in the short-term treatment of moderate to severe plaque psoriasis using network meta-analysis (NMA). Methods. A comprehensive literature search was performed in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for the available relevant studies. NMA was conducted by Stata 15.0 software using relative risks (RR) with 95% confidence interval to assess the clinical effectiveness and safety. Ranked the efficacy and safety for each drug accordance with the surface under the cumulative ranking curve (SUCRA). Results. This meta-analysis included 28 studies. All the interventions performed better than placebo in short-term achievement. Based on the result of SUCRA, ixekizumab 80 mg every 2 weeks ranked the highest in short-term achievement of PASI 75 (SUCRA = 93.0%). Brodalumab 210 mg ranked the highest in short-term achievement of PASI 100 (SUCRA = 85.0%). Secukinumab 300 mg ranked the highest in short-term achievement of sPGA 0/1 or IGA 0/1 or PGA 0/1 (SUCRA = 98.1%). In terms of having a risk of adverse events, the rates were higher in brodalumab, secukinumab, ixekizumab, and ustekinumab 45 mg compared with placebo. Ixekizumab 80 mg every 4 weeks ranked the highest in the risk of adverse events during short-term treatment (SUCRA = 4.5%). Guselkumab 50 mg ranked the highest in the risk of serious adverse events during short-term treatment (SUCRA = 25.9%). Ixekizumab 80 mg every 4 weeks ranked the highest in the risk of discontinuations due to adverse events during short-ter treatment (SUCRA = 10.7%). Conclusions. IL-17, IL-12/23, and IL-23 inhibitors had high efficacy in the achievement of PASI 75, PASI 100, and sPGA 0/1 or IGA 0/1 or PGA 0/1 in moderate to severe plaque psoriasis after 12 or 16 weeks of treatment. IL-17 inhibitors showed superior efficacy. However, its clinical safety was poor. Risankizumab appeared to have relatively high efficacy and low risk. The clinical tolerance of other biological agents needs to be further observed.http://dx.doi.org/10.1155/2019/2546161 |
| spellingShingle | Fan Bai Gang Gang Li Qingmin Liu Xinwu Niu Ruilian Li Huiqun Ma Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Journal of Immunology Research |
| title | Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials |
| title_full | Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials |
| title_short | Short-Term Efficacy and Safety of IL-17, IL-12/23, and IL-23 Inhibitors Brodalumab, Secukinumab, Ixekizumab, Ustekinumab, Guselkumab, Tildrakizumab, and Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials |
| title_sort | short term efficacy and safety of il 17 il 12 23 and il 23 inhibitors brodalumab secukinumab ixekizumab ustekinumab guselkumab tildrakizumab and risankizumab for the treatment of moderate to severe plaque psoriasis a systematic review and network meta analysis of randomized controlled trials |
| url | http://dx.doi.org/10.1155/2019/2546161 |
| work_keys_str_mv | AT fanbai shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials AT ganggangli shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials AT qingminliu shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials AT xinwuniu shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials AT ruilianli shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials AT huiqunma shorttermefficacyandsafetyofil17il1223andil23inhibitorsbrodalumabsecukinumabixekizumabustekinumabguselkumabtildrakizumabandrisankizumabforthetreatmentofmoderatetosevereplaquepsoriasisasystematicreviewandnetworkmetaanalysisofrandomizedcontrolledtrials |