Advantages of IL-17 inhibitor, ixekizumab, in the treatment of severe psoriasis

Abstract

Psoriasis is a common immune-mediated disease, often accompanied by inflammatory and metabolic disorders. About 20–30% of patients have moderate to severe psoriasis and require systemic methods of treatment, which include conventional, targeted and genetically engineered biological drugs (GEBDs). When selecting a biological agent, a number of factors must be considered related to the disease, patient and therapy. Assessment of severity and activity, area of skin affected, frequency of relapses, pruritus and other symptoms, the presence of comorbidities, especially psoriatic arthritis (PsA), are important. The presence of comorbidities that may contribute to or interfere with the use of GEBD is the main factor determining personalised therapy. Personalised treatment implies maximum efficacy and minimum risk of side effects. In addition, it is possible to modify the course of the disease, inducing long-term remission and preventing the development of PsA, which is possible in case of timely prescription of GEBD. To date, several classes of GEBDs are available in the arsenal of dermatovenerologists, among which interleukin (IL) inhibitors have the highest efficacy and safety. The drug ixekizumab is a member of the IL-17 inhibitor group, a monoclonal antibody of the IgG4 class that binds to IL-17A with high affinity and specificity. The drug has shown high efficacy and reliable safety profile in the treatment of psoriasis and PsA within the framework of numerous clinical trials and studies of real clinical practice, including in patients with an aggravated comorbid background and with involvement of hard-to-treat localisations. The presented article presents key data of safety and efficacy studies of ixekizumab therapy, describes a clinical case of successful treatment of a patient with psoriasis and psoriatic onychodystrophy. Timely initiation of therapy helped to stop the progression of the disease and significantly improved the quality of life of the patient. Thus, the presented data confirm the advantages of ixekizumab in psoriasis treatment.