{"id":335227,"date":"2019-11-28T00:00:00","date_gmt":"2019-11-27T23:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/outlook-on-possible-future-therapy-options\/"},"modified":"2019-11-28T00:00:00","modified_gmt":"2019-11-27T23:00:00","slug":"outlook-on-possible-future-therapy-options","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/outlook-on-possible-future-therapy-options\/","title":{"rendered":"Outlook on possible future therapy options"},"content":{"rendered":"<p><strong>As part of this year&#8217;s AAD, several speakers reported on  <\/strong><strong>on research-stage antipsoriatic agents, which showed promising results in phase 2 trials. Biologics and tyrosine kinase 2 inhibitors are among the drugs represented.  <\/strong><\/p>\n<p><strong><em><a href=\"https:\/\/www.medizinonline.ch\/atopische-dermatitis-und-psoriasis-news\" target=\"_blank\" rel=\"noopener\">Back to &#8220;Atopic dermatitis and psoriasis news&#8221;.<\/a><\/em><\/strong><\/p>\n<p> <!--more--> <\/p>\n<p>In addition to the monoclonal antibody Risankizumab, which was approved this year, several clinical studies on the efficacy and safety of other substances are currently underway, with positive interim results.<\/p>\n<h2 id=\"bimekizumab-good-outcomes-after-60-weeks\">Bimekizumab: good outcomes after 60 weeks<\/h2>\n<p>The results of the BE ABLE 1 and BE ABLE 2 extension studies indicate great potential of this monoclonal antibody for long-term maintenance therapy, as indicated in the presentation by Dr. Andrew Blauvelt, Oregon Medical Research Center [1]. Bimekizumab is a potent and selective neutralizer of IL-17A and IL-17F, two key proinflammatory cytokines.<\/p>\n<p>In the 12-week double-blind placebo-controlled phase 2 BE ABLE study&nbsp;1, bimekizumab resulted in rapid and substantial clinical improvement in moderate to severe plaque psoriasis with a safety profile comparable to previous studies of this agent [2]. Subjects were randomly assigned to experimental conditions and received bimekizumab subcutaneously at 4-week intervals at varying doses: 64&nbsp;mg, 160 mg, 160&nbsp;mg with dose escalation to 320&nbsp;mg, 320&nbsp;mg, 480 mg, or placebo. Primary endpoint was \u226590% reduction in Psoriasis Area Severity Index (PASI90) at week 12.<\/p>\n<p>Jeffrey Weinberg, M.D., Icahn School of Medicine, reported phase 2b data for bimekizumab. 50-60% of the highest dose groups achieved PASI 100 at week 12 [2]. In the BE ABLE 2 extension study (n=217), bimekizumab performed well in maintaining complete or near-complete lesion clearance in psoriasis patients over a 60-week period [3]. 80 to 100% of responders (all doses) to BE ABLE 1 showed maintenance of nearly 90% symptom reduction (PASI90) <strong>(Fig.&nbsp;1)<\/strong>. These positive results are currently the longest survey period.&nbsp; Phase 3 comparative studies of bimekizumab in psoriasis are being conducted based on these results.<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\" size-full wp-image-12585\" alt=\"\" src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2019\/11\/abb1_dp5_s38.png\" style=\"height:257px; width:600px\" width=\"1100\" height=\"472\"><\/p>\n<p>&nbsp;<\/p>\n<h2 id=\"bms-986165-dose-related-pasi-75-outcomes\">BMS-986165: dose-related PASI-75 outcomes.<\/h2>\n<p>Leon Kircik, M.D., Icahn School of Medicine Mount Sinai, New York, presented data from BMS-986165, a tyrosine kinase-2 inhibitor, which is classified as a Janus kinase (JAK) [4]. Tyrosine kinase-2 pathways play a mediating role for cytokines involved in the pathophysiology of psoriasis.<\/p>\n<p>A double-blind phase 2 study (n=267) was conducted to evaluate the efficacy of BMS-986165 in tablet form in adults with moderate to severe psoriasis. Subjects were randomly assigned to placebo or one of the verum conditions. After 12&nbsp;weeks, 75% of patients at a dose of 12 mg daily showed min. 75% reduction in PASI score (primary endpoint). In the subgroup with a dose of 6 mg twice daily, 67% achieved this target value; in that with a dose of 3 mg twice daily, 69%; and in that with 3 mg once daily, 39%. The differences from placebo were significant in each case (p&lt;0.001).<\/p>\n<p>The safety profile of JAK inhibitors has not been clearly established. Further long-term data are needed to investigate whether this class of compounds is associated with a statistically increased risk of infection and malignancy [5\u20137].  &nbsp;<\/p>\n<p>\n<em>Source: AAD, Annual Meeting 2019, Washington (USA)<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Literature:<\/p>\n<ol>\n<li>AAD: Annual Meeting February 28 &#8211; March 5, 2019, Washington, Dr. Andrew Blauvelt, Oregon Medical Research Center.<\/li>\n<li>Papp KA, et al: Dual neutralization of both interleukin 17A and interleukin 17F with bimekizumab in patients with psoriasis: results from BE ABLE 1, a 12-week randomized, double-blinded, placebo-controlled phase 2b trial. J Am Acad Dermatol. 2018; 79(2): 277-286.e10.<\/li>\n<li>Blauvelt A, et al: Dual Neutralisation Of Interleukin (Il)-17a And Il-17f With Bimekizumab In Moderate-To-Severe Plaque Psoriasis: 60-Week Results From A Randomised, Double-Blinded, Phase 2b Extension Study. https:\/\/ard.bmj.com\/content\/78\/Suppl_2\/1834.1<\/li>\n<li>AAD: Annual Meeting February 28 &#8211; March 5, 2019, Washington, Dr. Leon Kircik, Icahn School of Medicine Mount Sinai, New York.<\/li>\n<li>Winthrop KL: The emerging safety profile of JAK inhibitors in rheumatic disease. Nat Rev Rheumatol 2017; 13(4): 234-243.<\/li>\n<li>Verden A, Dimbil M, Kyle R, et al: Analysis of Spontaneous Postmarket Case Reports Submitted to the FDA Regarding Thromboembolic Adverse Events and JAK Inhibitors. Drug Saf 2018; 41: 357-361; 41(4): 357-361.<\/li>\n<li>Papp K, et al: Phase 2 Trial of Selective Tyrosine Kinase 2 Inhibition in Psoriasis. N Engl J Med 2018; 379: 1313-1321.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><em>DERMATOLOGIE PRAXIS 2019; 29(5): 38 (published 10\/10\/19, ahead of print).<\/em><\/p>\n<p><strong><em><a href=\"https:\/\/www.medizinonline.ch\/atopische-dermatitis-und-psoriasis-news\" target=\"_blank\" rel=\"noopener\">Back to &#8220;Atopic dermatitis and psoriasis news&#8221;.<\/a><\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As part of this year&#8217;s AAD, several speakers reported on on research-stage antipsoriatic agents, which showed promising results in phase 2 trials. 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