A Review of the Efficacy and Safety for Biologic Agents Targeting IL-23 in Treating Psoriasis With the Focus on Tildrakizumab.

Psoriasis is a chronic and debilitating inflammatory immune-mediated skin disorder. Several cytokines including interleukin (IL)-23 were demonstrated to play a central role in the pathogenesis of this disease. Treatment options for psoriasis range from topical to systemic modalities, depending on the extent, anatomical locations involved and functional impairment level. Targeting cytokines or their cognate receptors that are involved in disease pathogenesis such as IL-12/23 (i.e., targeting the IL-12p40 subunit shared by these cytokines), IL-17A, IL-17F, IL-17RA, and TNF-α using biologic agents emerged in recent years as a highly effective therapeutic option for patients with moderate-to-severe disease. This review provides an overview of the important role of IL-23 signaling in the pathogenesis of psoriasis. We describe in detail the available IL-23 inhibitors for chronic plaque psoriasis. The efficacy, pharmacokinetic properties, and the safety profile of one of the most recent IL-23 biologic agents (tildrakizumab) are evaluated and reviewed in depth.
Competing Interests: LK has received honoraria and research grants as a consultant, investigator, speaker, and/or advisory board member for Abbott, Acambis, Allergan, Amgen, Assos Pharma, Astellas Pharma US, Asubio, Berlex Laboratories (Bayer HealthCare Pharmaceuticals), Biogen Idec, Biolife, Biopelle, Breckinridge Pharma, Colbar, Celgene, Centocor, CollaGenex, Combinatrix, Connetics, Coria, Dermik Laboratories, Dow Pharmaceutical Sciences, Dusa, Embil Pharmaceuticals, EOS, Ferndale Laboratories, Galderma, Genentech, GlaxoSmithKline, Health Point, Intendis, Innovail, Johnson & Johnson, Laboratory Skin Care, LEO Pharma, 3M, Medical International Technologies, Merck, Medicis Pharmaceutical, Merz, Nano Bio, Novartis, Nucryst Pharmaceuticals, Obagi, Onset, OrthoNeutrogena, Promius, QLT, PharmaDerm, Pfizer, Quatrix, Serono (Merck Serono International SA), SkinMedica, Stiefel, Sun Pharmaceutical Industries, TolerRx, Triax, Valeant Pharmaceuticals Intl, Warner-Chilcott, and ZAGE. YP has received grant funding and honoraria for services as an investigator, speaker, and member of advisory boards from AbbVie, Amgen, Bausch, Janssen-Ortho, UCB Biopharma, and has received grant funding as an investigator from AnaptysBio, Arcutis biotherapeutics, Asana, Astrazeneca, Baxalta, Baxter, Boehringer Ingelheim, Bond Avillion, Bristol Myers Squibb, Celgene, Dermira, Devonian, Galderma, Genentech, Glaxo Smith Kline, Eli Lilly, Incyte, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sun Pharmaceutical Industries, Serono, Takeda. MB an advisory board member and speaker for AbbVie, Amgen, Leo Pharma, and Janssen; a speaker for Astellas and Merck; and an investigator for AbbVie, Astellas, Amgen, Leo Pharma, Novartis, Janssen, Sun Pharma, Lilly, Pfizer, and Celgene. RV was a speaker for AbbVie, Amgen, Celgene, Galderma, Janssen, Leo Pharma, Novartis, and Pfizer, and was an investigator for AbbVie, Amgen, Celgene, Galderma, Janssen, Leo Pharma, Novartis, Sun Pharmaceutical Industries, Pfizer, Lilly, and Merck. MW reports having received honoraria for ad board participation from Novartis, Sun Pharmaceutical Industries and Pfizer. CL was a consultant, speaker, and advisory board member for Amgen, Pfizer, AbbVie, Janssen, Novartis, and Celgene, and was an investigator for Amgen, Pfizer, AbbVie, Janssen, Lilly, Novartis, and Celgene. YP was a speaker and advisory board member for AbbVie, Amgen, and Janssen, and was an investigator for AbbVie, Amgen, Celgene, Centocor, Lilly, Galderma, Incyte, Sun Pharmaceutical Industries, Janssen, Leo Pharma, Merck, Novartis, Pfizer, and Roche. IL received research grant funding from Novartis, Merck, Abbvie, and Bristol Myers Squibb and honoraria from Janssen, Bausch, Galderma, Novartis, Pfizer, Sun Pharmaceutical Industries, Johnson & Johnson, and Actilion. Topics included in this article were based on, but not limited to, broad discussions at an advisory board meeting, which was sponsored and funded by Sun Pharma Canada, Inc. Consultancy fees were paid to meeting participants (LK, MB, YP, RV, MW, CL, and IL). Sun Pharma Canada, Inc., participated in developing the content for the meeting. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2021 Ghazawi, Mahmood, Kircik, Poulin, Bourcier, Vender, Wiseman, Lynde and Litvinov.)