IL-17 Antagonists Print Page

What are IL-17 Antagonists?

  • IL-17 Antagonists are in a family of medications called Biologics, a new class of DMARD (Disease Modifying Anti-Rheumatic Drug) which have been available recently.
  • While in the class of biologics like TNF antagonists, IL-17 antagonists do not work in the same way.
  • L-17 Antagonists are most commonly used in the treatment of ankylosing spondylitis and/or psoriatic arthritis.

What is the typical dose of an IL-17 Antagonist?

  • Secukinumab (Cosentyx) is given through an subcutaneous injection.  It is given weekly for the first month, and then every 4 weeks.
  • Ixekizumab (Taltz) is given through a subcutaneous injection.  It is given every 4 weeks.

How does Secukinumab work?

  • The immune system is made up of many different parts. By interfering with the correct part, it is possible to decrease the inflammation being caused by psoriatic arthritis, ankylosing spondylitis and similar diseases.
  • IL-17 blockers interferes with the immune system’s ability to communicate between certain types of cells by blocking a protein called IL17, thereby blocking its action and modulating the immune system’s response. This decreases inflammation, reduces pain, and improves function.

How soon will I feel the effects of IL-17 Antagonists?

  • They can take at least 1-3 months before starting to gain benefit.

If I start an IL-17 antagonist, can I stop all my other DMARDs?

  • IL-17 antagonists may be used on their own without other DMARDs, such as methotrexate. However, whether or not you continue with other DMARDs is a decision between you and your rheumatologist.
  • Keep in mind: In most instances, your rheumatologist has recommended you start a Biologic because your inflammatory arthritis has not been well controlled. It is important to try to control your disease as best as possible first, which may mean continuing all DMARDs for some time, before trying to decrease them.

What are the possible side effects of Secukinumab?

Side Effect Ways to Reduce Side Effects
  • Injection Site Reactions
  • If severe, the medication is stopped. However, certain medications can be given to prevent similar reactions from re-occurring.
  • IL-17 antagonists may increase your risk of developing severe infections.
  • Fevers and other severe illness should not be ignored. Discuss this with your doctor.  They will likely discuss postponing the injection until you are better.
  • If previously exposed to tuberculosis, IL-17 antagonists may increase your risk of causing it to become active. Your rheumatologist will do a TB skin test and chest x-ray to check if you have been exposed prior to starting the medication.
  • IL-17 antagonists does not appear to help inflammatory bowel disease.
  • Some patients with psoriatic arthritis or ankylosing spondylitis also have inflammatory bowel disease (IBD).  These medications do not appear to treat IBD and may cause IBD flares.  It should likely be avoided in this patient population.
  • Medication Interactions
  • Discuss vaccinations with your rheumatologist.
  • Live vaccines should be given prior to starting sucukinumab.

What should I do if I miss a dose?

  • It is safe to just stop IL-17 antagonists; you do not need to slowly reduce the dose. However, keep in mind, if you were gaining any benefit, it will usually take a few weeks to lose it.

 

For more information about IL-17 atagonists, or for questions that are specific to your situation, always consult your physician.



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