Candida infections in psoriasis and psoriatic arthritis patients treated with IL-17 inhibitors and their practical management

TY - JOUR

T1 - Candida infections in psoriasis and psoriatic arthritis patients treated with IL-17 inhibitors and their practical management

AU - Saunte, D M

AU - Mrowietz, U

AU - Puig, L

AU - Zachariae, C

N1 - This article is protected by copyright. All rights reserved.

PY - 2017/7

Y1 - 2017/7

N2 - The recognition of the central role of interleukin 17A (IL-17A) in the pathogenesis of psoriasis has led to the development of several monoclonal antibodies targeting this cytokine or its receptors for therapeutic purposes. IL-17A also plays an important role in the immunological protection against infections, especially those due to Candida sp., as evidenced by findings in patients with genetic defects in IL-17 related immune responses. To assess the potential of anti-Il-17 treatment to promote Candida infections, here we have systematically reviewed published clinical trials of patients with psoriasis or psoriatic arthritis. Candida infections were reported in 4.0% of patients treated with brodalumab, 2.1% with secukinumab, and 3.3% with ixekizumab, compared with 0.3%, 2.3% and 0.8% of those assigned to placebo, ustekinumab or etanercept, respectively. Although the incidence of Candida infection was found to be increased by a only small degree during anti-IL-17 therapy, patients undergoing such treatment should be monitored for fungal infection and treated as necessary. We propose to adopt the recently updated recommendations for the practical management of Candida infection in patients administered with IL-17 inhibitors. This article is protected by copyright. All rights reserved.

AB - The recognition of the central role of interleukin 17A (IL-17A) in the pathogenesis of psoriasis has led to the development of several monoclonal antibodies targeting this cytokine or its receptors for therapeutic purposes. IL-17A also plays an important role in the immunological protection against infections, especially those due to Candida sp., as evidenced by findings in patients with genetic defects in IL-17 related immune responses. To assess the potential of anti-Il-17 treatment to promote Candida infections, here we have systematically reviewed published clinical trials of patients with psoriasis or psoriatic arthritis. Candida infections were reported in 4.0% of patients treated with brodalumab, 2.1% with secukinumab, and 3.3% with ixekizumab, compared with 0.3%, 2.3% and 0.8% of those assigned to placebo, ustekinumab or etanercept, respectively. Although the incidence of Candida infection was found to be increased by a only small degree during anti-IL-17 therapy, patients undergoing such treatment should be monitored for fungal infection and treated as necessary. We propose to adopt the recently updated recommendations for the practical management of Candida infection in patients administered with IL-17 inhibitors. This article is protected by copyright. All rights reserved.

U2 - 10.1111/bjd.15015

DO - 10.1111/bjd.15015

M3 - Review

C2 - 27580411

SN - 0007-0963

VL - 177

SP - 47

EP - 62

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 1

ER -