Mark Lebwohl, MD: The Evolving Treatment Landscape of IL-17 Inhibitors

Mark Lebwohl, MD, is dean for Clinical Therapeutics and chairman emeritus of the Department of Dermatology at the Icahn School of Medicine at Mount Sinai.

Ahead of the 2023 Society of Dermatology Physician Assistants (SDPA) Fall Conference in Nashville, TN, Lebwohl spoke with Dermatology Times to discuss important updates and considerations in the world of IL-17 inhibitors, which he presented a session on at the conference.

Transcript:

Mark Lebwohl, MD: Hi, I'm Mark Lebwohl. I'm the dean for clinical therapeutics at the Icahn School of Medicine at Mount Sinai, and I am chairman emeritus of the Department of Dermatology here.

We did a lot of work that led to the approval of IL-17 blockers for psoriasis, still, among the favorite medications that I use, and a lot of excitement recently, in particular, because just in the last week, bimekizumab was approved by the FDA, and that's a drug that's long overdue. It's actually been used in much of the rest of the world for the last almost 2 years, and we are the last ones to get it, but I think it's going to have a very positive impact on the way we practice.

I'm giving a lecture on tips in the use of IL-17 blockers, and there's several questions that I'm addressing and topics I'm addressing. So for example, "Can you overdose on IL-17 blockers?" The answer is a resounding no. The bottom line is that the IL-17 blockers are very safe, and it is very difficult to overdose on them.

Another area where IL-17 blockade is effective as in patients with psoriatic arthritis, and it's even been used in patients who failed TNF blockers, IL-7 blockers and namely secukinumab, ixekizumab, and brodalimuab are indeed effective for psoriatic arthritis. Of course, bimekizumab is just recently approved for psoriasis, but it is dramatically effective for psoriatic arthritis. And in fact, not only is it equally effective to adalimumab, but when you take patients who failed adalimumab and treat them with bimekizumab, it is dramatic, which is something that deserves mention. Psoriatic arthritis another very useful area where IL-17 blockade is helpful.

IL-17 blockers, of note, do not interfere with vaccinations at all. So in this era of flu shots, COVID shots, and RSV shots, you can take them literally the same day as the IL-17 blocker and not have a negative impact. IL-17 blockers are not approved for guttate psoriasis, but we showed several years ago, in a group of patients who developed guttate psoriasis, that they could be cleared very quickly with IL-17 blockers, and often after 3 or 4 months, the treatment could be discontinued, and the psoriasis would not return. So there is another useful utility for IL-17 blockers that we didn't think of before.

[Transcript has been edited for clarity.]

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