The dark side of the moon: the immune-mediated adverse events of IL-17A/IL-17R inhibition

J Dermatolog Treat. 2022 Aug;33(5):2443-2454. doi: 10.1080/09546634.2022.2062281. Epub 2022 Apr 8.

Abstract

As aberrant IL-17 signaling plays a critical role in the pathogenesis of psoriasis, biologic agents targeting this pathway have become an important weapon against this disease. Some biologic agents such as IL-17 inhibitors (secukinumab and ixekizumab) and the IL-17 receptor (IL17R) inhibitor (brodalumab) are relatively safe, tolerable and efficacious drugs. Nevertheless, side effects of IL-17 pathway inhibition occur. This review focuses on the dermatological manifestations linked to these treatments. Paradoxical psoriasis and atopic-like eczema may be the most common cutaneous adverse events, while manifestations such as neutrophilic dermatoses, hypersensitivity reactions, lichenoid eruptions, vasculitides, bullous diseases, lupus-like reactions, pigmentation disorders, adnexal diseases and granulomatous dermatoses have been described less frequently.

Keywords: Biologic therapy; IL-17; brodalumab; ixekizumab; secukinumab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal
  • Biological Factors / adverse effects
  • Biological Factors / therapeutic use
  • Female
  • Humans
  • Interleukin-17* / antagonists & inhibitors
  • Psoriasis* / chemically induced
  • Psoriasis* / drug therapy
  • Receptors, Interleukin / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Biological Factors
  • Interleukin-17
  • Receptors, Interleukin