IL-17 Inhibitors: Expanding Therapeutic Horizons in Dermatology and Rheumatology

IL-17 inhibitors are reshaping therapeutic strategies in dermatology and rheumatology, pushing boundaries beyond plaque psoriasis to also embrace complex conditions like psoriatic arthritis and hidradenitis suppurativa.

While IL-17 blockade has significantly advanced psoriasis treatment through selective targeting of IL-17A and IL-17F pathways, expanding its application to disorders with distinct immunopathology presents a pressing challenge for clinicians managing heterogeneous inflammatory patterns.

IL-17 inhibitors like sonelokimab and izokibep are emerging as promising treatments for psoriatic arthritis and are under investigation for hidradenitis suppurativa, with preliminary phase II data suggesting improved efficacy and tissue targeting.

In psoriatic arthritis, IL-17 inhibitors achieve ACR20 response rates comparable to TNF inhibitors (e.g., 60% vs. 58%), with similar efficacy for axial involvement specific to psoriatic arthritis, and are endorsed as alternatives in the 2023 EULAR and GRAPPA guidelines, as highlighted by comparative effective strategies for psoriatic arthritis.

Beyond approved therapies, emerging IL-17 inhibitors like izokibep and bimekizumab are advancing through clinical development, reflecting robust responses across immune-mediated diseases in recent studies.

Safety profiles underscore that while IL-17 inhibitors are linked with increased candidiasis risk, their overall tolerability remains acceptable. Vigilant monitoring is recommended, especially with long-term use, as detailed in safety assessments.

For patients unresponsive to first-line biologics, integrating IL-17 inhibitors offers a vital alternative and reinforces the need for personalized strategies based on disease phenotype and treatment history, as explored in treatment personalization studies. This aligns with data previously discussed on expanded indications.

As novel agents mature and real-world experience grows, IL-17 inhibition is poised to redefine standards of care in dermatology and rheumatology, with implications extending into broader immune-mediated conditions.

Key Takeaways:

• IL-17 inhibitors are broadening their therapeutic reach beyond psoriasis, effectively targeting psoriatic arthritis and hidradenitis suppurativa.
• Comparative efficacy research supports IL-17 inhibitors as viable alternatives to traditional TNF therapies for complex cases.
• Emerging agents like sonelokibep, izokibep, and bimekizumab suggest robust future applications in autoimmune disease management.
• Despite risks, the safety profile of IL-17 inhibitors remains acceptable, necessitating ongoing infection monitoring.