Interleukin-23 Blockers: Born to be First-line Biologic Agents in Inflammatory Bowel Disease?

Curr Pharm Des. 2019;25(1):25-31. doi: 10.2174/1381612825666190313140811.

Abstract

Over the past decades, the advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD. However, primarily and more importantly, secondary loss of response to anti-TNF agents, is often observed. Thus, new treatment options have been actively explored and some have already been incorporated in the current clinical practice. Among the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have been first presented, in clinical practice, by the anti-p40 mAb ustekinumab in Crohn's disease (CD). More selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream, which have failed in IBD clinical trials despite their clear efficacy in psoriasis.

Keywords: Crohn's disease; IL-23; Th17 cell pathway cytokines; inflammatory bowel disease; monoclonal antibody anti-IL23; ulcerative colitis..

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Biological Products / therapeutic use*
  • Clinical Trials as Topic
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases / therapy*
  • Interleukin-23 / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Ustekinumab / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Biological Products
  • Gastrointestinal Agents
  • Interleukin-23
  • Tumor Necrosis Factor-alpha
  • Ustekinumab