Psoriasis is a chronic, systemic inflammatory disease that in the moderate to severe forms may benefit of biologics, namely TNF and IL-12/23 and IL-17 inhibitors. Loss of response, lack of response or discontinuation due to adverse events represent a concrete therapeutic challenge for dermatologists that have to switch patients to other treatments. Although some evidences already exist toward the switch from IL-12/23 and TNF inhibitors to IL-17 inhibitors, conversely nothing is present toward the switch from IL-17 inhibitors to IL-12/23 and TNF inhibitors. We performed a real-life study enrolling 50 patients randomly switched to adalimuamb, a TNF inhibitor, or ustekinumab, an IL-12/23 inhibitor. Our observational study suggests that switching from IL-17i to TNFi and IL-12/23i is a safe and effective therapeutic strategy. This article is protected by copyright. All rights reserved.
Damiani, G., Conic, R. R., de Vita, V., Costanzo, A., Regazzini, R., Pigatto, P. D., Bragazzi, N. L., Pacifico, A., & Malagoli, P. (2018). When IL-17 inhibitors fail: real-life evidence to switch from secukinumab to adalimumab or ustekinumab. Dermatologic Therapy, e12793. https://doi.org/10.1111/dth.12793