Researchers at Stanford University undertook a proof of concept, open label phase 1b clinical trial investigating the use of secukinumab (Cosentyx, Novartis) in patients with moderate-to-severe papulopustular rosacea. This study is evaluating change in the number of papules/pustules from baseline to week 16 as its primary endpoint. Adverse events, along with changes in overall severity by global assessment, erythema, quality-of-life measures and immune infiltrate are being looked at as secondary outcomes. Results are forethcoming.
Dr. Vender notes that secukinumab, which is a recombinant human monoclonal IgGi/k antibody that binds to IL-17A, may be the best candidate to study for the treatment of rosacea because it was the first to market and has a longer history of use than brodalumab (Siliq, Valeant Pharmaceuticals) and ixekizumab (Taltz, Eli Lilly and Co.). Secukinumab may also have a safety advantage.
“Brodalumab has a broader spectrum of action as it blocks multiple IL-17 cytokines versus just IL-17A, but brodalumab carries a black box warning,” Dr. Vender says. “The high cost of IL-17 inhibitors currently prohibits their use in diseases other than for their approved indications in psoriasis and psoriatic arthritis. Data from clinical trials would be needed to justify expanding their use to rosacea,” he adds.
Dr. Vender has received grants and/or research support from companies that market IL-17 inhibitors and treatments for rosacea. He received no financial support for the research, authorship or publication of his article on IL-17 and rosacea.
Amir ali A, Vender R, Vender R. The Role of IL-17 in Papulopustular Rosacea and Future Directions. J Cutan Med Surg. 2019;:1203475419867611.