Authors’ Reply to Wang et al., “Comment on ‘Efficacy and Safety of Brodalumab, an Anti‑interleukin‑17 Receptor A Monoclonal Antibody, for Palmoplantar Pustulosis: 16‑Week Results of a Randomized Clinical Trial’”

• Published in: American journal of clinical dermatology 2024-11, Vol.25 (6), p.1025-1027
• Main Authors: Okubo, Yukari, Kobayashi, Satomi, Murakami, Masamoto, Sano, Shigetoshi, Kikuta, Natsuko, Ouchi, Yoshiumi, Terui, Tadashi
• Format: Article
• Language: English
• Subjects: Clinical trials; Cytokines; Dermatology; Disease; Drug therapy; Infections; Letter to the Editor; Medicine; Medicine & Public Health; Monoclonal antibodies; Pathogenesis; Patients; Pharmaceuticals; Pharmacology/Toxicology; Pharmacotherapy; Psoriasis; Tumor necrosis factor-TNF
• ISSN: 1175-0561; 1179-1888; 1179-1888
• DOI: 10.1007/s40257-024-00896-7

Bimekizumab, a selective IL-17 inhibitor, led to improvement in patients with PPP, albeit in a case series, suggesting its potential use for treating PPP [10]. [...]the available evidence supports the role of IL-17 pathway inhibitors against PPP. In our trial, AEs such as eczema and rash occurred in more than 5% of patients, with aggravation of PPP observed in 3/126 patients [2]. [...]as PPP demonstrates diverse presentation and is associated with focal infections [3], the possibility that some patients may have primary inefectiveness or worsening skin symptoms with treatment cannot be ruled out. Additionally, cytokine assays using enzyme-linked immunosorbent assay (ELISA) dem‑ onstrated a significant elevation in serum levels of IL-17 in patients with PPP relative to healthy controls [13]. Many aspects of the disease mechanism of PPP are not yet completely understood, and it is possible that the diversity of the pathophysiology could be manifested as differences in treatment responses, to both focal infection treatment and drug therapy.