Efficacy and safety of interleukin-17 inhibitors in the treatment of chronic rheumatic diseases: A combined and updated meta-analysis.

WHAT IS KNOWN AND OBJECTIVE:

To assess the efficacy and safety of interleukin-17 inhibitors (ixekizumab, secukinumab, bimekizumab, netakimab and brodalumab) in chronic inflammatory rheumatic diseases, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA).

METHODS:

A comprehensive search for randomized controlled trials (RCTs) evaluating efficacy and safety of interleukin-17 inhibitors was performed through PubMed, Embase and Cochrane Library databases. Quality assessment was performed using the Cochrane Collaboration risk of bias tool. Data were pooled using the fixed or random-effects models.

RESULTS AND DISCUSSION:

Twenty RCTs were identified: of these 9 studies on patients with AS and 11 studies on patients with PsA. Concerning clinical efficacy, a pooled analysis showed interleukin-17 inhibitors had a higher response rate for the primary endpoint (p < 0.05) and secondary endpoint (p < 0.05) at the treatment endpoint for AS/PsA patients. Moreover, an increased risk of treatment-emergent adverse events and infection was found in AS patients (p < 0.05). In contrast, no increased risk of any adverse events was reported in PsA patients.

WHAT IS NEW AND CONCLUSION:

In this meta-analysis, our findings found interleukin-17 inhibitors had a significant clinical benefit in the management of AS/PsA patients.