Intraclass Switching among IL17 Inhibitors in Psoriasis: A Real‐Life, Long‐Term Single‐Center Experience

Abstract

Interleukin 17 (IL‐17) inhibitors such as secukinumab, ixekizumab, and IL17 receptor (IL17RA) inhibitor brodalumab have proved to be highly effective and safe in psoriasis treatment. Still, a substantial proportion of patients show a primary or secondary inefficacy. When this happens, the clinician can change the therapeutical axis (swap) or perform an intraclass switch among IL‐17 inhibitors. The latter option could allow us to address some comorbidity better, spare the other axis in case of the future inefficacy, and avoid interacting with other molecules with a different safety profile. To date, no sufficient data are available on the efficacy of a second IL‐17 inhibitor therapy. Our study included 29 patients with moderate to severe psoriasis undergoing an intraclass switch among IL‐17 inhibitors. The mean PASI dropped from 11.1 ± 6.1 to 5.2 ± 6.6 at week 16, with response maintained at week 28 and week 52 (3.4 ± 4.2 and 3.0 ± 4.3, respectively) with no occurrence of serious adverse events. Our data support the evidence that intraclass switch among IL‐17 inhibitors is a safe and effective therapeutic option in these patients. This trial is registered with SS_DERMO_20.