Journal of Clinical and Aesthetic Dermatology

Updates on Psoriasis & Cutaneou Oncology

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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S11 P r o c e e D i n G s JCAD jOUrnAl Of ClInICAl And AEsthEtIC dErMAtOlOgy september 2017 • volume 10 • number 9 • supplement (clear) or 1 (minimal) on the five-point investigator Global assessment (iGa) score at 16 weeks (85.1% vs. 6.9%, respectively, p<0.001). 7 a greater proportion of guselkumab patients scored Pasi 90 compared to placebo patients (73.3% vs. 2.9%). compared to adalimumab, signifcantly greater proportions of guselkumab patients scored 0 or 1 on the iGa at Weeks 16, 24, and 48 (85.1% vs. 65.9%, 84.2% vs. 61.7%, and 80.5% vs. 55.4%, respectively) and signifcantly more guselkumab patients achieved Pasi 90 at Weeks 16, 24, and 48 (73.3% vs. 49.7%, 80.2% vs. 53.0%, and 76.3% vs. 47.9%, respectively). the voyaGe2 trial (a study of Guselkumab in the treatment of Participants With Moderate to severe Plaque- type Psoriasis With randomized Withdrawal and retreatment nct02207244) 8 reported better persistence of response in the guselkumab maintenance group versus the withdrawal arm of the study (p<0.001) from Weeks 28 to 48. about two-thirds of the adalimumab nonresponders (66.1%) who were switched to guselkumab at Week 28 achieved Pasi 90 at Week 48. the rate of adverse events was similar among groups for both voyaGe1 and voyaGe2. Risankizumab. risankizumab is a novel anti- il-23 monoclonal antibody (Bi 655066) that was recently studied for safety, eecacy, and pharmacokinetic properties in a frst-in-human, proof-of-concept study, designed as a single- rising-dose, randomized, double-blind, placebo-controlled trial. 9 eighteen patients with moderate-to-severe plaque psoriasis received 0.01, 0.05, 0.25, 1, 3, or 5mg/kg of risankizumab intravenously (iv), 0.25 or 1mg/kg risankizumab subcutaneously (n=13), or matched placebo (n=8). adverse events were similar in the active and control groups. risankizumab was associated with clinical improvement commencing around Week 2 and maintained by 33 percent of those treated up to 66 weeks after treatment. Pasi 75, Pasi 90, and Pasi 100 scores were achieved at 12 weeks by 87, 58, and 16 percent of risankizumab patients, respectively; no placebo patients scored in this range. 7 as such, risankizumab may be considered an "immunologic disrupter." third-generation biologics. IL-17 inhibitors. il-17 inhibitors include secukinumab, ixekizumab, and brodalumab. there are clear diderences in these three agents in terms of structure and signaling, 10 although all three may be considered next-generation biologics (figure 1). Secukinumab. the sculPture study (eecacy and safety of subcutaneous secukinumab [ain457] for Moderate to severe chronic Plaque-type Psoriasis assessing Diderent Doses and Dose regimens [sculPture] nct01406938), presented at the european academy of Dermatology and venereology congress in vienna in 2016 by Bissonnette et al, demonstrated durable edectiveness of secukinumab in a four-year observed analysis. 11 at the end of year 4 (n=131), 88.5, 66.4, and 43.5 percent of secukinumab patients had Pasi 75, Pasi 90, and Pasi 100 scores, which were similar to frst-year results (n=162) of 88.9, 68.5, and 43.8 percent, respectively. the rate of treatment-emergent adverse events remained similar over the years (78.0% at year 1, 75.0% at year 2, 69.4% at year 3, 62.0% at year 4) with the most frequently reported adverse events being nasopharyngitis, upper respiratory tract infection, headache, and pharyngitis. neither Mace nor opportunistic infections (other than candida infections) occurred in four years. 11 Ixekizumab. ixekizumab has been the focus of numerous recently published studies. 12 the long-term results from a Phase 2 study (a study in Participants With Moderate to severe Psoriasis nct01107457) of fve-year safety and eecacy were recently presented at the american association of Dermatology (aaD) scientifc sessions. subcutaneous ixekizumab figure 1. structure and signaling of il-17 inhibiting third-generation biologics; 7 il: interleukin reproduced with permission from lønnberg et al. targeting of interleukin-17 in the treatment of psoriasis. Clin Cosmet Investig Dermatol. 2014;7: 251–259. Published online 2014 sep 15. doi: 10.2147/cciD.s67534. copyright © 2014 lønnberg et al.

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