For a study, researchers conducted a systematic review of the efficacy and safety of interleukin 6 (IL-6) inhibitors canakinumab, IL-12/23 inhibitor ustekinumab, and IL-17A inhibitors secukinumab, brodalumab, and ixekizumab in patients with psoriatic arthritis (PsA). MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science were used to perform the literature search. Researchers included randomized controlled studies that looked at the effectiveness of IL inhibitors and reported an American College of Rheumatology 20 response at 24 weeks. The DerSimonian and Laird technique was used for meta-analysis with a random-effects model. The RobotReviewer Cochrane Risk-of-Bias Assessment Tool was used to evaluate the quality. The Q statistic was used to evaluate heterogeneity, while I2 was used to quantify it. A funnel plot was used to examine publication bias.
About 8 trials including 2,722 patients showed that the IL inhibitors canakinumab, secukinumab, ixekizumab, brodalumab, and ustekinumab were effective in the treatment of PsA. The risk ratios for therapy against placebo were 2.02 (95% CI, 1.65–2.47; P=0.000), 2.95 (95% CI, 2.32–3.73; P=0.00), and 5.14 (95% CI, 3.28–8.06; P=0.00), respectively. There was no indication of considerable trial heterogeneity. Subgroup analysis revealed effectiveness in tumor necrosis factor naïve individuals, as well as tumor necrosis factor nonresponders or poor responders. The frequency of adverse events in the treatment groups was greater than in the placebo groups, although the majority were moderate and did not necessitate treatment modification (risk ratio, 1.17; 95% CI, 1.06–1.28; P=0.001). There was no statistically significant difference in drug discontinuation.
When used to treat individuals with PsA, inhibitors of IL-6 (canakinumab), IL-12/23 (ustekinumab), and IL-17A (secukinumab, brodalumab, ixekizumab) were effective and typically well-tolerated, according to the meta-analysis.