Targeting IL-17A for the treatment of pustular psoriasis: a comprehensive review

Expert Opin Biol Ther. 2022 Dec;22(12):1475-1487. doi: 10.1080/14712598.2022.2116978. Epub 2022 Aug 25.

Abstract

Introduction: Pustular psoriasis (PP) is a rare subtype of psoriasis. Overall, the growing evidence - in particular for acute generalized PP (GPP) - supports that it is a separate entity with a specific pathogenetic pathway. Interleukin (IL)-17/T-helper 17 (Th17) axis involvement may play an important role in the pathophysiology of PP. Biologicals, often required to achieve clinical remission, have changed the treatment of PP.

Areas covered: We provide the reader with an overview of all the available evidence on the use of the antibody-based therapy targeting IL-17A in patients with PP.

Expert opinion: Although papers reported in this review do not provide definitive evidence (due to methodological limitations) to support the use of IL-17 inhibitors as potential first-line for the treatment of PP, based on our own experience and according to most of the reported literature, targeting IL-17A, may represent the best therapeutical approach in this peculiar clinical spectrum of psoriasis.

Keywords: IL-17A; acrodermatitis continua of Hallopeau; acute generalized pustular psoriasis; biologics; brodalumab; ixekizumab; pustular psoriasis; secukinumab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products* / therapeutic use
  • Humans
  • Interleukin-17
  • Psoriasis* / drug therapy

Substances

  • Interleukin-17
  • Antibodies, Monoclonal, Humanized
  • Biological Products