Psoriasis: Targets and Therapy (Jan 2018)
Targeting IL-23 in psoriasis: current perspectives
Abstract
Christina Fotiadou, Elizabeth Lazaridou, Eleni Sotiriou, Demetrios Ioannides First Department of Dermatology and Venereology, Aristotle University Medical School, Thessaloniki, Greece Abstract: The recent advances in the understanding of psoriasis pathogenesis have clarified the pivotal role of interleukin (IL)-23. It is a heterodimeric cytokine consisting of two subunits, the unique p19 and the p40, which are shared with IL-12. The basic role of IL-23 in psoriasis is the activation and maintenance of the T-helper 17 pathway. New research findings indicate that IL-23 is more important than IL-12 in the pathogenesis of psoriasis. Based on that background, the selective targeting of the IL-23p19 subunit emerged as an attractive therapeutic option and led to the development of a new category of biologic agents. Three monoclonal antibodies that selectively inhibit the IL-23p19 subunit, guselkumab, tildrakizumab, and risankizumab, are in the pipeline for the treatment of moderate-to-severe psoriasis. In this article, we review the most recent efficacy and safety data regarding these IL-23p19 inhibitors. Keywords: psoriasis, IL-23, treatment, Th17 axis, anti-IL-23p19 monoclonal antibodies