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2) Our expert author is Dr. Steven Feldman @DrSteveFeldman, dermatologist, scientist, & journal editor from @wakehealthin. Also lending content to this program are Bruce Strober MD PhD and Mark Lebwohl MD. pic.twitter.com/FjW1fBBKx5
a) Only IL‑17A (not other IL17s) are ⬆️in lesions b) IL‑17A/C/F levels ⬇️sharply w/ effective tx c) IL‑17‑targeted biologics are highly effective psoriasis treatments d) Drugs effective for psoriasis & #PsA are also effective for #IBD
6) So let's get started! We will briefly explore the science & clinical impact of IL‑17 pathway blockade in #dermatology, with a focus on moderate–severe #psoriasis and related conditions. pic.twitter.com/sGmCmr8PAV
8) And we'll focus on safety, including warnings in @US_FDA labels, putting risks of #IBD exacerbation, serious infections, fungal infection, liver injury, & suicidality in perspective with new long-term data from #EADV2025. pic.twitter.com/SPZL4BC5oJ
11) Currently IL-17 inhibitors have a number of indications, including #psoriasis, psoriatic arthritis #PsA, other joint issues, but--interestingly--not for inflammatory bowel disease #IBD. pic.twitter.com/g4VMq0C2wA
13a) In fact, IL-17 blockers have occasionally been associated with development of #Crohn's, and so we don't use these agents in pts who already have Crohn's. All that notwithstanding, our faculty members hold that we see very few adverse effects with IL-17 receptors. Why?
15b) Most cases were mild-mod in severity & usu did not ➡️drug d/c. Majority of pts had only 1 episode. When it does occur, tx is straightforward with #fluconazole; occ add oral #nystatin. If it IS recurrent, consider empiric fluconazole at the time of dosing #bimekizumab.
17b) #Brodalumab blocks the IL-17 receptor & hence inhibits IL17A and F subtypes. Studies of mental health AEs with #bimekizumab suggest tx may actually be beneficial—as reducing psoriasis may reduce associated #depression. pic.twitter.com/jZUJvalsiU
19) Now we turn to latest data--from #AAD2025 & #EADV2025--specifically on #bimekizumab (inhibitor of IL-17 A+F) and long-term safety. 5-yr data from multiple clinical trials: what are the major concerns and what are their frequencies? pic.twitter.com/uEsNq3jk9G
21) And data from #EADV25: with clearing of #psoriasis (#PASI 100), so presumably very potent IL17 inhibition with 4yr #bimekizumab, rates of #AEs are reassuringly low, w/no #IBD signal, no psych signal. Also, it appears AE levels at wk 16 of tx are predictive of long-term AEs. pic.twitter.com/o93wl47x1X
23) Main concern, then, is #candidiasis, which we can treat. #Psych AEs not > background rates. No special concerns re 🫀disease or cancer. Should avoid use in pts with known #IBD. Long-term objective data are of great value—the IL-17 blockers are effective & FAST in #psoriasis!
