From Evolution to Revolution: IL-23 in the Treatment of Psoriasis Patients

Abstract

This symposium, which took place during the 2018 meeting of the European Academy of Dermatology and Venereology (EADV) in Paris, France, provided an overview of the IL-23 revolution in psoriasis, with a specific focus on psoriasis pathogenesis and its relation to potential treatment targets and the development of novel targeted immune therapies. The session focussed on the discovery and development of IL-12 and IL-23-targeted therapies for psoriasis, the role of IL-23 in disease control, and the implications of recent data for clinical practice. An increasing number of potential treatment options are becoming available for psoriasis, and the differential effect of these agents on various signalling pathways has facilitated a greater understanding of the molecular mechanisms driving disease progression. The symposium initially explored the central role of IL-23 in psoriasis, the mode of action of the monoclonal antibody (mAb) guselkumab in targeting this heterodimeric cytokine, and the parameters associated with a maintenance of response in patients with psoriasis undergoing treatment. The speakers subsequently reviewed current data relevant to the blockade of IL-23 versus dual blockade of IL-12/23, or blockade of the downstream effector IL-17, and the relative effects of these different strategies in psoriasis at the molecular and cellular levels. The concept of ‘disease memory’ in psoriasis was also explored, with an examination of recent data of patients with long-lasting remission, and disease models and future investigations discussed.