Interleukin-17 inhibition: a route to psoriasis clearance?

Recent advances in the understanding of the role of the interleukin-17 pathway in protection against pathogens helped to define theoretical risks of interleukin-17 inhibitors, which primarily consist of fungal and bacterial infections.5 In keeping with these models is the higher incidence of infection in patients given ixekizumab than in those given etanercept, and a few observations of non-invasive Candida spp infection in patients given ixekizumab (eight in patients receiving ixekizumab every 2 weeks, four in patients receiving ixekizumab every 4 weeks, five in those receiving etanercept, and one in a patient receiving placebo),2 which were also reported in the secukinumab trial.3 Another safety signal that could emerge is reflected by two cases of Crohn's disease in patients who received ixekizumab in UNCOVER-2 and UNCOVER-3,2 one characterised by a worsening course of pre-existing Crohn's disease and the other of new onset disease, both in the higher dose ixekizumab group.