Short-term effect and safety of a new generation of monoclonal antibodies targeting interleukin-23p19 for treatment of psoriasis: a systematic review and meta-analysis

Background The effect and safety of monoclonal antibodies (mAbs) targeting the interleukin-23 (IL-23) p19 subunit for treatment of psoriasis has not previously been systematically evaluated. Objectives To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) (including P...

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Bibliographic Details
Published in:EJD. European journal of dermatology 2019-05, Vol.29 (3), p.302-314
Main Authors: Hou, Min, Xing, Haiyan, Cai, Yongqing, Wang, Xianfeng, Xie, Zhaolu, Zhang, Qing, Ma, Yunqi, Chen, Jianhong
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - administration & dosage
Antineoplastic Agents, Immunological - administration & dosage
Dermatology
Female
Humans
Interleukin-23 Subunit p19 - immunology
Male
Medicine
Medicine & Public Health
Molecular Targeted Therapy - methods
Patient Safety
Psoriasis - drug therapy
Psoriasis - immunology
Psoriasis - pathology
Randomized Controlled Trials as Topic
Therapy
Treatment Outcome
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Summary:Background The effect and safety of monoclonal antibodies (mAbs) targeting the interleukin-23 (IL-23) p19 subunit for treatment of psoriasis has not previously been systematically evaluated. Objectives To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) (including Phase I-III trials) to evaluate the efficacy and safety of these mAbs for treatment of psoriasis. Materials and Methods The databases of PubMed, Baidu Scholar, and Cochrane Library of Clinical Trials were searched from inception of the databases to January 1 st , 2018. A systematic review and meta-analysis was conducted using Review Manager Software version 5.3 (RevMan 5.3). Results Nine RCTs with a total of 2,478 subjects met our inclusion criteria. A significant increase in PASI 75 (RR: 11.65; 95% CI: 9.01-15.06), PASI 90 (RR: 21.74; 95% CI: 14.28-33.10), PASI 100 (RR: 31.56; 95% CI: 14.66-67.96), PGA 0/1 (OR: 23.21; 95% CI: 14.61-36.89), and DLQI 0/1 (RR: 10.29; 95% CI: 7.52-14.09) was identified for anti-IL-23p19 mAb vs. placebo, and PASI 75 (RR: 1.25; 95% CI: 1.18-1.32), PASI 90 (OR: 2.56; 95% CI: 2.13-3.09), PASI 100 (OR: 2.38, 95% CI: 1.89- 2.99), and DLQI 0/1 (RR: 1.33; 95% CI: 1.20-1.47) vs. tumour necrosis factor (TNF) antagonists for the treatment of psoriasis. Furthermore, there was no significant difference in adverse events between placebo and TNF antagonists. Conclusion Anti-IL-23p19 mAbs are effective with acceptable safety as therapy for psoriasis, and may be superior to TNF antagonists. More RCTs with a larger sample size are required to verify the current findings.
ISSN:1952-4013
1952-4013
DOI:10.1684/ejd.2019.3553