IL-17 Inhibitors

Source
  • Fully human
Mechanism of Action
  • Monoclonal IgG1 that binds IL17A
Half-life
  • 22-31 days
Pregnancy Category
  • Pregnancy Category B
Dose
  • Subcutaneous
  • 300 mg at weeks 0, 1, 2, 3 and 4 then monthly maintenance 
  • 150mg can be considered in patient less than 90 kg
Indications
  • FDA Dermatology: Psoriasis and Psoriatic arthritis
Contraindications
  • Absolute: hypersensitivity reaction, live vaccine, active infection, malignancy 
  • Relative: inflammatory bowel disease
Side Effects
  • Injection site reaction
  • URTI
  • Nasopharyngitis
  • Increase risk of mucocutaneous candida (5%)
  • Neutropenia in 1-2%
Notes
  • Use with cautious in IBD
  • 75-85% PASI75

Source
  • Humanized
Mechanism of Action
  • Monoclonal IgG4 that binds IL17A and neutralizes it
Half-life
  • 13 days
Pregnancy Category
  • No FDA category assigned
Dose
  • Subcutaneous
  • 160 mg as loading dose then 80 mg every 2 weeks for 3 months; then 80 mg every 4 weeks
Indications
  • FDA Dermatology: Psoriasis and Psoriatic arthritis
Notes
  • Use with cautious in IBD
  • Approved for children 6 years old and older 
  • 85-90% PASI75

Source
  • Human
Mechanism of Action
  • Monoclonal IgG2 IL17 receptor A antagonist
Half-life
  • 11 days
Pregnancy Category
  • No FDA category assigned
Dose
  • Subcutaneous
  • 210 mg at weeks 0, 1, and 2; then, every 2 weeks
Indications
  • FDA Dermatology: Psoriasis
Contraindications
  • Same as above + absolute contraindication in IBD
Side Effects
  • Same as above + suicidal ideation 
Notes
  • Black box warning about suicidal ideation
  • Contraindicated in patient with IBD
  • Fastest onset of action among targeted immune modulator 
  • 80-85% PASI75

Source
  • Humanized
Mechanism of Action
  • Monoclonal IgG1 antibody against IL17A and IL17F
Half-life
  • 26 days
Pregnancy Category
  • Unknown
Dose
  • Subcutaneous
  • 320 mg every 4 weeks
Indications
  • In clinical trials for psoriasis but not approved yet 
Contraindications
  • No data
Side Effects
  • Nasopharyngitis
  • Oral Candidiasis
Notes
  • BE VIVID trial compared to Ustekinumab (Phase III)
  • 85% PASI90