Terapia imunológica com inibidor da interleucina-17 no tratamento de psoríase vulgar
DOI:
https://doi.org/10.29237/2358-9868.2020v8i1.p178-189Palavras-chave:
Psoríase; Terapia biológica; Secukinumab; Ixekizumabe; Brodalumabe; Interleucina-17.Resumo
A psoríase é uma doença inflamatória crônica sistêmica de grande impacto na qualidade de vida dos doentes. Tem como apresentação mais frequente a psoríase em placas ou psoríase vulgar. Quadros leves da doença são tratados inicialmente com medicações tópicas, enquanto quadros moderados/graves podem ter a terapia tópica associada a fototerapia e, eventualmente, combinada a terapia sistêmica, ou ainda opção do uso de imunobiológicos. O uso de imunobiológicos tem se mostrado uma boa opção para o tratamento da psoríase moderada/grave, apresentando melhores resultados na redução dos sintomas e melhora da qualidade de vida do paciente. Entre os medicamentos imunobiológicos inibidores da IL-17 destacam-se o secuquinumabe, ixekizumabe e brodalumabe. Objetivos: Abordar a eficácia do uso de imunobiológicos inibidores da IL-17 (secukinumab, brodalumabe e ixekizumab) no tratamento da Psoríase moderada a grave. Conclusão: O Ixekizumab foi considerado o imunobiológico mais eficaz no tratamento a curto prazo para psoríase em placas moderada a grave em termos de PASI 75 e PASI 90, seguido por Secukinumab e Brodalumab. Embora os efeitos a curto prazo dos agentes biológicos na psoríase moderada a grave estejam bem documentados, estudos que examinam a eficácia e a segurança a longo prazo são mais limitados e carecem de melhores avaliações.
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2. Pathirana D., et al. "European S3‐Guidelines on the systemic treatment of psoriasis vulgaris: Supported by the EDF/EADV/IPC." Journal of the European Academy of Dermatology and Venereology. 2009;23:1-70.
3. Marinoni B, et al. The Th17 axis in psoriatic disease: pathogenetic and therapeutic implications. Auto Immun Highlights. 2014;5:9-19.
4. Deng Y, Chang C, Lu Q. The Inflammatory Response in Psoriasis: a Comprehensive Review. Clin Rev Allergy Immunol, 2016;50:377-89.
5. Silva M, et al. Psoriasis: correlation between clinical severity (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment. An Bras Dermatol. 2013;5:760-63.
6. Lopes L, et al. Medicamentos biológicos para o tratamento de psoríase em sistema público de saúde. Rev. Saúde Pública, São Paulo. 2014;4:651-61.
7. Hong C, et al. Patients with psoriasis have different preferences for topical therapy, highlighting the importance of individualized treatment approaches: randomized phase IIIb PSO‐INSIGHTFUL study. Journal of the European Academy of Dermatology and Venereology. 2017;11:1876-83.
8. Vide J, Magina S. Moderate to severe psoriasis treatment challenges through the era of biological drugs. An. Bras. Dermatol., Rio de Janeiro. 2017;92(5):668-674.
9. Faria J, et al. Importância da variação do PASI realizado por diversos observadores. Anais Brasileiros de Dermatologia. 2010;5:625-9.
10. Mansouri M, et al.The potential role of Th17 lymphocytes in patients with psoriasis. An Bras Dermatol. 2018;93(1):63-66.
11. Torres T, Filipe P. Interleukin-17 as a therapeutic target in psoriasis. Acta Med Port 2014;27(2):252-8.
12. Roman M, Chiu MW. Spotlight on brodalumab in the treatment of moderate-to-severe plaque psoriasis: design, development, and potential place in therapy. Drug Design, Development and Therapy; 2017;11:2065-2075.
13. Marti L, et al. Alterations in cytokine profile and dendritic cells subsets in peripheral blood of rheumatoid arthritis patients before and after biologic therapy. Ann N Y Acad Sci. 2009;1173:334-42.
14. Galluzzo M, et al. Brodalumab for the treatment of psoriasis,Expert Review of Clinical Immunology. 2016;12(12):1255-1271.
15. Jinna S, Strober B. Anti-interleukin-17 treatment of psoriasis.Journal of dermatological treatment. 2016;27(4):311-315.
16. Maddur M, et al. Th17 cells: biology, pathogenesis of autoimmune and inflammatory diseases, and therapeutic strategies. Am J Pathol. 2012;1:181:8-18.
17. Mrowietz U. Implementing treatment goals for successful long-term management of psoriasis. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2): 12–20.
18. Nast A, et al. EuropeanS3-Guidelines on the systemic treatment of psoriasis vulgaris - Update 2015 - Short version - EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29:2277-94.
19. Lonnberg AS, et al. Targeting of interleukin-17 in the treatment of psoriasis. Clinical, cosmetic and investigational dermatology. 2014;7:251–259.
20. Blauvelt A, et al. Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: Results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3). Journal of the American Academy of Dermatology. 2017;77(5):855-862.
21. Bagel J, et al. The effect of secukinumab on moderate-to-severe scalp psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study. Journal of the American Academy of Dermatology. 2017;77(4):667-674.
22. Bissonnette R, et al. Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study). Journal of the European Academy Dermatology and Venereology. 2018;32(9):1507-1514.
23. Lunder T, et al. Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis. Int J Dermatol. 2019;58(6):631-641.
24. Yajima A, et al. Alopecia Diffusa while Using Interleukin-17 Inhibitors against Psoriasis Vulgaris. Case Rep Dermatol. 2019;11:82–85.
25. Wcislo-Dziadecka D, et al. Are new variants of psoriasis therapy (IL-17 inhibitors) safe? Int J Dermatol. 2019. doi: 10.1111/ijd.14509
26. Chiricozzi A CHIRICOZZI, A; KRUEGER, J. IL-17 targeted therapies for psoriasis. Expert Opin. Invest. Drugs. 2013;22(8):993-1005.
27. Blauvelt A, Prinz JC, Gottlieb AB, Kingo K, Sofen H, Ruer-Mulard M, Singh V, Pathan R, Papavassilis C, Cooper S; FEATURE Study Group. Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE).Br J Dermatol. 2015 Feb;172(2):484-93.
28. Melinda G, et al. Interleukin-17 (IL-17) inhibitors in the treatment of plaque psoriasis: a review. Skin Therapy Lett. 2015;20(1):1-5.
29. CONITEC, Comissão Nacional de Incorporação de Tecnologias no SUS. ADALIMUMABE, ETANERCEPTE, INFLIXIMABE, SECUQUINUMABE E USTEQUINUMABE PARA PSORÍASE MODERADA A GRAVE. Relatório para sociedade. Disponível em: <www.conitec.gov.br >. Acesso em 17 jul. 2018.
30. Langley RG, et al. Secukinumab in plaque psoriasis—results of two phase 3 trials, N. Engl. J. Med. 2014;371:326–338.
31. Gordon K, et al., Phase 3 trials of Ixekizumab in moderate-to-severe plaque psoriasis, N. Engl. J. Med. 2016;375:345–356.
2. Pathirana D., et al. "European S3‐Guidelines on the systemic treatment of psoriasis vulgaris: Supported by the EDF/EADV/IPC." Journal of the European Academy of Dermatology and Venereology. 2009;23:1-70.
3. Marinoni B, et al. The Th17 axis in psoriatic disease: pathogenetic and therapeutic implications. Auto Immun Highlights. 2014;5:9-19.
4. Deng Y, Chang C, Lu Q. The Inflammatory Response in Psoriasis: a Comprehensive Review. Clin Rev Allergy Immunol, 2016;50:377-89.
5. Silva M, et al. Psoriasis: correlation between clinical severity (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment. An Bras Dermatol. 2013;5:760-63.
6. Lopes L, et al. Medicamentos biológicos para o tratamento de psoríase em sistema público de saúde. Rev. Saúde Pública, São Paulo. 2014;4:651-61.
7. Hong C, et al. Patients with psoriasis have different preferences for topical therapy, highlighting the importance of individualized treatment approaches: randomized phase IIIb PSO‐INSIGHTFUL study. Journal of the European Academy of Dermatology and Venereology. 2017;11:1876-83.
8. Vide J, Magina S. Moderate to severe psoriasis treatment challenges through the era of biological drugs. An. Bras. Dermatol., Rio de Janeiro. 2017;92(5):668-674.
9. Faria J, et al. Importância da variação do PASI realizado por diversos observadores. Anais Brasileiros de Dermatologia. 2010;5:625-9.
10. Mansouri M, et al.The potential role of Th17 lymphocytes in patients with psoriasis. An Bras Dermatol. 2018;93(1):63-66.
11. Torres T, Filipe P. Interleukin-17 as a therapeutic target in psoriasis. Acta Med Port 2014;27(2):252-8.
12. Roman M, Chiu MW. Spotlight on brodalumab in the treatment of moderate-to-severe plaque psoriasis: design, development, and potential place in therapy. Drug Design, Development and Therapy; 2017;11:2065-2075.
13. Marti L, et al. Alterations in cytokine profile and dendritic cells subsets in peripheral blood of rheumatoid arthritis patients before and after biologic therapy. Ann N Y Acad Sci. 2009;1173:334-42.
14. Galluzzo M, et al. Brodalumab for the treatment of psoriasis,Expert Review of Clinical Immunology. 2016;12(12):1255-1271.
15. Jinna S, Strober B. Anti-interleukin-17 treatment of psoriasis.Journal of dermatological treatment. 2016;27(4):311-315.
16. Maddur M, et al. Th17 cells: biology, pathogenesis of autoimmune and inflammatory diseases, and therapeutic strategies. Am J Pathol. 2012;1:181:8-18.
17. Mrowietz U. Implementing treatment goals for successful long-term management of psoriasis. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2): 12–20.
18. Nast A, et al. EuropeanS3-Guidelines on the systemic treatment of psoriasis vulgaris - Update 2015 - Short version - EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29:2277-94.
19. Lonnberg AS, et al. Targeting of interleukin-17 in the treatment of psoriasis. Clinical, cosmetic and investigational dermatology. 2014;7:251–259.
20. Blauvelt A, et al. Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: Results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3). Journal of the American Academy of Dermatology. 2017;77(5):855-862.
21. Bagel J, et al. The effect of secukinumab on moderate-to-severe scalp psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study. Journal of the American Academy of Dermatology. 2017;77(4):667-674.
22. Bissonnette R, et al. Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study). Journal of the European Academy Dermatology and Venereology. 2018;32(9):1507-1514.
23. Lunder T, et al. Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis. Int J Dermatol. 2019;58(6):631-641.
24. Yajima A, et al. Alopecia Diffusa while Using Interleukin-17 Inhibitors against Psoriasis Vulgaris. Case Rep Dermatol. 2019;11:82–85.
25. Wcislo-Dziadecka D, et al. Are new variants of psoriasis therapy (IL-17 inhibitors) safe? Int J Dermatol. 2019. doi: 10.1111/ijd.14509
26. Chiricozzi A CHIRICOZZI, A; KRUEGER, J. IL-17 targeted therapies for psoriasis. Expert Opin. Invest. Drugs. 2013;22(8):993-1005.
27. Blauvelt A, Prinz JC, Gottlieb AB, Kingo K, Sofen H, Ruer-Mulard M, Singh V, Pathan R, Papavassilis C, Cooper S; FEATURE Study Group. Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE).Br J Dermatol. 2015 Feb;172(2):484-93.
28. Melinda G, et al. Interleukin-17 (IL-17) inhibitors in the treatment of plaque psoriasis: a review. Skin Therapy Lett. 2015;20(1):1-5.
29. CONITEC, Comissão Nacional de Incorporação de Tecnologias no SUS. ADALIMUMABE, ETANERCEPTE, INFLIXIMABE, SECUQUINUMABE E USTEQUINUMABE PARA PSORÍASE MODERADA A GRAVE. Relatório para sociedade. Disponível em: <www.conitec.gov.br >. Acesso em 17 jul. 2018.
30. Langley RG, et al. Secukinumab in plaque psoriasis—results of two phase 3 trials, N. Engl. J. Med. 2014;371:326–338.
31. Gordon K, et al., Phase 3 trials of Ixekizumab in moderate-to-severe plaque psoriasis, N. Engl. J. Med. 2016;375:345–356.
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2020-07-13
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