L’IL-23 est-elle la gagnante? Leçons tirées des maladies inflammatoires de l’intestin (MII) et du psoriasis (PsO)
Résumé
Principaux points à retenir
• L’interleukine-23 (IL-23) et l’interaction entre l’IL-23 et les Th-17 jouent un rôle central dans la pathogenèse des maladies à médiation immunitaire, telles que le psoriasis (PsO) et les maladies inflammatoires de l’intestin (MII). Cela a mené à la mise au point et à la commercialisation de plusieurs traitements anti-IL-23, qui ont tous démontré leur grande efficacité et leur innocuité dans la prise en charge de ces maladies.
• Il s’est avéré que les traitements anti-IL-23 sont parmi les plus efficaces dans le PsO. Ils permettant d’obtenir une réponse significative et durable au traitement (PASI-90) chez plus de 80 % des participants aux études cliniques d’enregistrement, tandis que dans les MII, l’efficacité significative à un an, reposant sur les diverses définitions des critères d’évaluation principaux des études, est obtenue (au mieux) chez un peu plus de 50 % des participants, bien que les taux de rémission soient beaucoup plus faibles dans la maladie de Crohn.
• Plusieurs études en cours évaluant le rôle de l’inhibition de l’IL-23 dans des populations atteintes d’une MII spécifique (par exemple, la maladie de Crohn périanale), et des études évaluant l’association des inhibiteurs de l’IL-23 avec d’autres traitements ciblés, tirent profit de l’excellent profil d’innocuité et d’efficacité des agents anti‑IL-23, ce qui reflète l’importance à long terme de ces traitements dans le paysage thérapeutique des MII.
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