title: Efficacy and safety of interleukin-17 antagonists in patients with plaque psoriasis: a meta-analysis from phase 3 randomized controlled trials.
abstract: BACKGROUND
  The interleukin-17 (IL-17) cytokine pathway plays a key role in the development of psoriasis. Antibodies targeting IL-17 or blocking its receptor may be a new therapeutic approach for psoriasis. To assist treatment selection in daily practice, it is essential to understand the benefit and risk profile of IL-17 antagonists.
  
  
  OBJECTIVE
  We performed a meta-analysis to evaluate the efficacy and safety of IL-17 antagonists in patients with psoriasis.
  
  
  METHODS
  We searched a number of databases for relevant randomized controlled trials (RCTs) published before May 2016. The following outcomes were evaluated: Psoriasis Area and Severity Index (PASI) 75, 90, 100 response, Investigator's Global Assessment (IGA) score of 0 or 1 response, adverse events (AEs) and withdrawals. The meta-analysis was performed using Review Manager 5.2 software.
  
  
  RESULTS
  Nine RCTs with 5951 patients were included. IL-17 antagonists achieved higher PASI 75, 90, 100 response rates and Dermatology Life Quality Index 0 or 1 response rates than placebo and a lower incidence of discontinuations due to lack of efficacy. In the safety analysis, no significant differences were found between the IL-17 antagonists and placebo in the proportion of patients with serious AEs, cardiovascular disease and discontinuations due to AEs. However, IL-17 antagonists were associated with a higher proportion of patients with any AEs and infections than placebo.
  
  
  CONCLUSIONS
  IL-17 antagonists were effective, with an acceptable safety profile, for patients with plaque psoriasis. Vigilance because of the potential for infection will be necessary for IL-17 antagonists.
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: D
authors.initials: D
authors.lastname: Wu
authors.affiliation: Intensive Care Unit, The People's Hospital of Liaoning Province, Shenyang, Liaoning, China.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Hou
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: L-X
authors.initials: LX
authors.lastname: Hou
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: T
authors.initials: T
authors.lastname: Jiao
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: N-N
authors.initials: NN
authors.lastname: Xu
authors.affiliation: Second Departments of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: N
authors.initials: N
authors.lastname: Zhang
mesh_terms: D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D020381:Interleukin-17 / Q000037:antagonists & inhibitors*; D011565:Psoriasis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D020381:Interleukin-17