Efficacy of a second IL-17 inhibitor in patients with psoriasis: a systematic review and meta-analysis.

Multiple biologics for psoriasis exist and interleukin (IL)-17 inhibitors are among those with best efficacy. However, switching treatment is often required at some point and intraclass switch of IL-17 inhibitors is not well investigated.To determine the efficacy of a second IL-17 inhibitor in patients with psoriasis.Two independent authors searched the databases PubMed and EMBASE for studies reporting on efficacy of IL-17 inhibitors in patients with psoriasis previously exposed to another IL-17 inhibitor. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.In total, 14 publications comprising 655 patients were included. The proportion of patients achieving psoriasis area severity index (PASI) 75, PASI90, and PASI100 were respectively 74.6 (95% confidence interval [CI]: 63.9-84.0), 69.4% (95% CI: 53.2-83.4), and 46.4 (95% CI: 30.5-62.7) after short-term treatment (week 9, 12, and 16 combined).Most studies included were on ixekizumab and were retrospective chart reviews with no information on response to previous IL-17 inhibitor.Previous treatment with an IL-17 inhibitor does not appear to affect the efficacy of another IL-17 inhibitor in treatment of psoriasis. However, further prospective studies are needed.

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