Effectiveness of TNF-α blockers and IL-12/IL-23 blockers in the treatment of Psoriasis. Preliminary observations. Wojciech Francuzik, Kinga Byczkowska Student working group at The Clinic of Skin Diseases and Medical Mycology, Poznań University of Medical Sciences. Supervisor: Professor Zygmunt Adamski MD PhD
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Effectiveness of TNF-α blockers and IL-12/IL-23 blockers in the treatment of Psoriasis. Preliminary observations.
Presentation during International Medical Student Congress in Poznań. 1st award in dermatology session.
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Effectiveness of TNF-α blockers and
IL-12/IL-23 blockers in the treatment of
Psoriasis.
Preliminary observations.
Wojciech Francuzik, Kinga Byczkowska
Student working group
at The Clinic of Skin Diseases and Medical Mycology,
Poznań University of Medical Sciences.
Supervisor: Professor Zygmunt Adamski MD PhD
Biological Agents
● Used in dermatology, rheumatology and
gastroenterology
● Block pathways of inflammtion
pharmatching.com
Interleukin IL-12 in the pathogenesis of
psoriasis
Dendritic Cells
Macrophages
Keratinocytes
Mast cells
Granulocytes Th0
Th1
NK Other
cytokines
IgG
IL-12
Interleukin IL-23 in the pathogenesis of
psoriasis
Langerhans C
Macrophages
Keratinocytes
Th17
Th17
activ
e
Induce
s
CD8+ cytotoxicit
y
IL-23
TNF-α in the pathogenesis of psoriasis
Langerhans C
Macrophages
Keratinocytes
Mast cells
● Elevated concentration in changed skin
● Induces migration of macrophages
● Stimulates LC maturation
● Stimulates proinflammatory cytokines production
● Induces proliferation of keratinocytes
Structure of cytokines important in the
pathogenesis of psoriasis
Nature Reviews Immunology
TNF-α
Acts trough:
TNF-RI
TNF-RII
Current Protocols.com
The agents used in the treatment of
psoriasis
Infliximab Etanercept Adalimumab Ustekinumab
Chimeric
antibody
Human
antibody
Human
fusion protein
Human
antibody
TNF-α blockers
IL-12, IL-23
Blocker
p40 subunit
i.v. 5mg/kg
0-2-4-8 w
Than every 8 w
s.c. 50 mg
Every week
i.m. 40 mg
Every 2 weeks
s.c. 45mg
0-4-12 w
Than every 12 w
Aim of this study:
To verify which biologic agent (infliximab,
adalimumab, etanercept, ustekinumab) used in
the treatment of psoriasis is the most effective
in reducing skin changes.
Materials and methods:
51 psoriatic patients
Infliximab Etanercept Adalimumab Ustekinumab
15 12 11 13
PASI 0
(at day 0)
PASI 0
(at day 0)
PASI 0
(at day 0)
PASI 0
(at day 0)
After 4 weeks
of therapy
PASI 4 PASI 4 PASI 4 PASI 4
After 12 weeks
of therapy
PASI 12 PASI 12 PASI 12 PASI 12
● Calculating a percentile PASI reduction after 4
weeks of therapy
● Calculating a percentile PASI reduction after 12
weeks of therapy
Materials and methods:
Pred4= PASI 4
PASI 0
Pred12= PASI 12
PASI 0
Results:
● There is a difference beetween means in the 4 agents