Anti-IL-17 Drugs: A Guide
Interleukin-17 (IL-17) is a protein that plays a crucial role in the body’s immune response. While it’s important for fighting infections, too much IL-17 can lead to inflammation and various autoimmune diseases, such as psoriasis, psoriatic arthritis, and ankylosing spondylitis. Anti-IL-17 drugs, also known as IL-17 inhibitors, are used to manage these conditions by blocking the action of IL-17. An important advantage of these drugs is that they are not involved in cancer surveillance, making them potentially safer for individuals with a history of cancer or concerns about cancer risk. Below is a guide to the main anti-IL-17 drugs currently on the market.
1. Secukinumab (Cosentyx)
• Indications: Used for moderate to severe plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis (nr-axSpA).
• Dosing: Typically, an initial dose of 300 mg (two 150 mg injections) at weeks 0, 1, 2, 3, and 4, followed by 300 mg every 4 weeks. For some conditions, 150 mg every 4 weeks may be sufficient.
• Potential Major Side Effects: Infections (especially upper respiratory infections), headache, diarrhea, and risk of exacerbating inflammatory bowel disease.
• Monitoring: Regular monitoring for signs of infection and new or worsening symptoms of inflammatory bowel disease.
2. Ixekizumab (Taltz)
• Indications: Treats moderate to severe plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis (nr-axSpA).
• Dosing: Initial dose is 160 mg (two 80 mg injections) followed by 80 mg every 2 weeks for 12 weeks, then 80 mg every 4 weeks for psoriasis. For psoriatic arthritis, ankylosing spondylitis, and nr-axSpA, the dose is 160 mg initially, then 80 mg every 4 weeks.
• Potential Major Side Effects: Injection site reactions, infections (such as upper respiratory infections), nausea, and risk of inflammatory bowel disease.
• Monitoring: Similar to Secukinumab, monitoring for infections and symptoms of inflammatory bowel disease is important.
3. Brodalumab (Siliq)
• Indications: Primarily used for moderate to severe plaque psoriasis in adults who have not responded well to other systemic therapies.
• Dosing: An initial dose of 210 mg at weeks 0, 1, and 2, followed by 210 mg every 2 weeks.
• Potential Major Side Effects: Infections, headache, joint pain, fatigue, and risk of suicidal thoughts and behavior.
• Monitoring: Close monitoring for signs of infection and any new or worsening depression or suicidal thoughts.
Key Points About Anti-IL-17 Drugs
1. Indications: These medications are mainly used for chronic inflammatory conditions such as psoriasis, psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis (nr-axSpA). They help reduce symptoms and improve the quality of life.
2. Dosing: Dosing schedules vary, typically starting with a loading phase followed by maintenance doses. It’s crucial to follow the dosing schedule prescribed by a healthcare provider to maintain effectiveness.
3. Side Effects: Common side effects include injection site reactions and infections. More serious risks include the potential worsening of inflammatory bowel disease and, for brodalumab, suicidal thoughts. Patients should be aware of these risks and communicate any concerns to their healthcare provider.
4. Monitoring: Regular monitoring is essential to ensure the medication is working effectively and to detect any adverse effects early. This includes routine checks for infections and other potential side effects.
5. Cancer Considerations: An important advantage of anti-IL-17 drugs is that they are not involved in cancer surveillance. This makes them potentially safer for individuals with a history of cancer or those who have concerns about cancer risk. This aspect can provide peace of mind for patients worried about the long-term implications of their treatment.
Conclusion
Anti-IL-17 drugs are a powerful option for managing certain autoimmune and inflammatory spinal conditions. While they offer significant benefits in controlling symptoms and improving patient outcomes, they also come with risks that require careful monitoring. Patients using these medications should maintain open communication with their healthcare providers to ensure safe and effective treatment.