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Expanding the IL-17 Therapeutic Landscape
IL-17 inhibitors are an effective therapeutic for a broad spectrum of inflammatory and autoimmune diseases and its blockade has revolutionized management of diseases such as psoriasis, psoriatic arthritis and SpA. Is there a need for more medications within the same therapeutic class?
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Putting IL17i into ‘focus’ for SpA-associated uveitis
The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than golimumab and certolizumab pegol.
Other data have emerged for JAKi and IL17i, with respect to acute anterior uveitis.
Data from COAST-V study (post hoc)
🔹️Ixekizumab in #axSpA
🔹️Efficacy stratified by CRP level
🔹️Better treatment response in the elevated compared to the normal CRP group
OP0699
#EULAR2025
@RheumNow https://t.co/1mVoly3Gws
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🫁 In autoimmune ILD patients from FIBRONEER-ILD (n=325), nerandomilast slowed FVC decline vs placebo and reduced risk of ILD progression events (HR 0.56 for 18 mg BID).
Acceptable safety profile & tolerability.
@RheumNow #EULAR2025 #LB0003 https://t.co/aWsfNOL76n
Mrinalini Dey DrMiniDey ( View Tweet)
Guselkumab in APEX study (PsA, n=1020, biologic-naïve):
🦴 Less joint damage: 0.55 vs 1.35 (placebo)
💪 More responders: 67–68% hit ACR20 on GUS
🛡 Safety: similar to placebo
GUS - selective IL-23i - delivers joint protection and symptom relief
LB0010 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
APEX study Ph3 RCT Guselkumab
In BioNaive active PsA w/ erosions>=2
wk 24
ACR20 GUS Q4W 67% Q8W 68% vs PBO 47%
Less Rx progression in both Q4W & Q8W vs. PBO
#EULAR2025 @RheumNow LB0010 https://t.co/OVDWWECtOZ
Aurelie Najm AurelieRheumo ( View Tweet)
Hidradenitis suppurativa is newer to us in rheumatology, but it seems like inflamm arthritis is a problem - at least to a similar extent as in psoriasis.
Time for us to look for it & to see what therapies like IL-17 inhibitors do for this arthritis
#EULAR2025 POS1237 @RheumNow https://t.co/b5EQdDEAhq
David Liew drdavidliew ( View Tweet)
👁️Uveitis in axSpA:
-Up to 40% can present before SpA dx
-NMA of 44 RCTs showed tx with TNFi, JAKi and IL-17i protective effects against uveitis
-Low rates of uveitis in axSpA pts on BIME trials suggests its possible beneficial effects.
#EULAR2025
@RheumNow https://t.co/mPuSMnD1Zs
Links:
Adela Castro AdelaCastro222 ( View Tweet)
In real-world PsA, IL-23 inhibitors (guselkumab/risankizumab) showed clinical response in axial/mixed PsA. Best response seen in pts meeting ASAS axial SpA criteria (RR 7.64) & baseline ASDAS-CRP >2.1. Supports role of patient stratification in axial PsA. Abstract#POS0113 https://t.co/qowZZmJOpM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Efficacy and Safety of Xeligekimab in AS
Dr. Adela Castro reports on abstract OP0102 at the EULAR 2025 meeting in Barcelona, Spain
https://t.co/xpzeV0oZOr https://t.co/wmTnFbFcum
Links:
Dr. John Cush RheumNow ( View Tweet)
In PsA, can we better pick IL-17A inhibitor responders (after TNFi failure)?
Transcriptomic profiling is going to get better at telling us which pathways are truly important for response to specific treatments
POS0232 #EULAR2025 @RheumNow https://t.co/uycuXB0TFK
David Liew drdavidliew ( View Tweet)
In #axSpA post #TNFi-IR
What to use next?
👇
#ATTRA registry
90% #SpA on #bDMARDs are captured
Comparison of
TNFi to ▶️
2nd TNFi vs
#IL17i
▶️No diff in #retention
✅better #BASDAI and other outcomes w TNFi!
❎less safety
🤔
#EULAR2025 @RheumNow @eular_org
Abst#POS0116 https://t.co/7mqFfD4Amf
Janet Pope Janetbirdope ( View Tweet)
2-year #MANDARA data: Benralizumab shows durable remission, eosinophil suppression & OGC-sparing in EGPA. ~62-68% in remission at wk104. Low relapse rate, no loss of asthma control or decline of lung function. No new safety signals.
@RheumNow #EULAR2025 #OP0166 https://t.co/kXh2q2ilJF
Mrinalini Dey DrMiniDey ( View Tweet)
Exciting results from ARGO trial:
-Phase 2 of Sonelokimab (dual IL-17A-IL17F) nanobody in PsA.
-Met primary endpoint of ACR50 at week 12 vs PBO.
-62% achieved MDA
-48% achieved composite of ACR 70+PASI 100
Looking forward to phase 3 results!!!
Abstract #OP0096 #EULAR2025 https://t.co/1D52eG8ReS
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Secukinumab for PMR?
-post hoc analysis of the TitAIN study (phase 2 RCT on new onset/relapsing GCA) showed:
-Numerical reduction in patients experiencing PMR symptoms when treated with secukinumab compared to placebo.
-Safety profile was similar to the overall GCA study
Adela Castro AdelaCastro222 ( View Tweet)
Biomarker data suggest TNFi non-responders in PsA exhibit upregulation of IL-17F gene signatures after treatment failure. Supports IL-17A/F blockade rationale with bimekizumab in TNFi-experienced patients Abstract#OP0091 @RheumNow . #EULAR2025 https://t.co/CWR6ArDRRW
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Real-world study on dual bDMARD plus JAKi or TYK2i combinations in refractory PsA. 22 PsA patients on dual bDMARD + JAKi/TYK2i:
•Most common: IL-17i + TYK2i
•Total exposure: 8.5–10.5 pt-years
•Only mild URIs/stomatitis
•Clinical improvements seen in joint/skin domains https://t.co/waDReDqSDE
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Precision immunotherapy in axial spondyloarthritis: TRBV9xCD3 bispecific antibodies selectively depleted autoreactive TRBV9+ T cells from HLA-B27+ AS patient samples while sparing over 95 percent of the T cell repertoire. TRBV9xCD3 bispecific antibodies selectively depleted https://t.co/8UXqEaDYnS
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
VEGF-Grab (PB101/PB102), dual VEGF/PlGF decoy receptor, inhibited angiogenesis, RA-FLS invasion, and Th17 cell differentiation in RA and MS models. PB102 reduced IL-17 and GM-CSF co-expressing Th17 cells, suppressed pannus and joint destruction in CIA, and outperformed IFN-β in https://t.co/qhVRYT4RbK
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Cool technology reduces dose interval of #IL17AFi
To…every 6 to 12 months!
#Antibody ORKA-002 has end of arms w YTE substitution prolonging circulation of drug
Lasts longer than #bimekizumab
Easier for adherence!
#EULAR2025 @RheumNow @eular_org #abstPOS0016 https://t.co/KcKaIe0WMs
Links:
Janet Pope Janetbirdope ( View Tweet)
