- Dermatologists, rheumatologists, but most of all patients suffering from psoriatic arthritis, are waiting for interleukin 23 inhibitors to be reimbursed also in our country - said Prof. dr hab. n. med. Joanna Narbutt, National Consultant for Dermatology and Venereology.
Patients with PsA are waiting for reimbursement of IL-23 inhibitors
Published Oct. 13, 2022 08:34
prof. Joanna Narbutt
What treatments are already available for patients with psoriatic arthritis and what are their needs not yet met?
Psoriatic arthritis is a very serious disease that often accompanies psoriasis. Young people often suffer from it and, if left untreated, it leads to disability. For several years we have been lucky to use modern biological therapies. We do have a large portfolio of drugs. We have TNF-alpha and interleukin 17 inhibitors. We use them after the failure of classic drugs, such as methotrexate or non-steroidal anti-inflammatory drugs, depending on the form of PsA. However, medicine, pharmacy and technology are moving forward, and therefore there are already new molecules - interleukin 23 inhibitors, which are registered in PsA. Dermatologists, rheumatologists and, above all, patients are waiting for them to be reimbursed also in our country. Unfortunately, some patients either stop responding to other modern therapies at some stage, or do not have this response from the very beginning. If interleukin 23 inhibitors were reimbursed, i.e. very modern drugs with a very good safety profile, which is also extremely important for patients, we would have everything that the world has. Our patients would no doubt be pleased.
What are the greatest benefits of using IL-23 inhibitors for patients? You mentioned the security profile.
The patient wants effective treatment, and this drug works quickly. It is very important. The patient wants to have a treatment that is convenient to use, i.e. he would not want to give himself injections every day or once a week, only at greater intervals. This enables him to function normally, i.e. going to work or going on vacation. Both the patient and the doctor attach great importance to the safety of the therapy. It is surprising that in the treatment of immunologically mediated chronic diseases, such as Psoriasis, psoriasis, Crohn's disease, and ulcerative colitis, the more modern the therapies are, the higher their safety profile. We have extensive experience with interleukin 23 inhibitors in the treatment of psoriasis because we have had this reimbursement for some time. So far, we have not seen any serious side effects in patients receiving these drugs. By including interleukin 23 inhibitors on the reimbursement lists, we give patients what they expect: fast action, high clinical efficiency and a high safety profile.
What is the route of administration? Are these drips or subcutaneous injections?
These are, fortunately, injections, or subcutaneous injections. Depending on the system adopted in a given ward, patients receive them during follow-up visits. Sometimes, when a patient is away, he or she may receive two home doses, as these are self-administered medications. If we could, we'd just prescribe them. This also demonstrates the high safety profile of these drugs.
How are drug programs structured? Does the patient have to go through other steps such as anti-inflammatory treatment? Maybe there is a need to prescribe these drugs in the first line of treatment?
When we have a patient, we would like to help him very quickly. However, we know that classic disease-modifying drugs, such as methotrexate, are not bad drugs either. They are older and obviously have a different safety profile, they work slower, generally the clinical effect is obtained in a smaller population, but they are also not completely to be deleted. So it seems to me that even if biological drugs are the next line of treatment, but in the appropriate population they would be administered without problems, we also get a very good benefit. Ideally, however, it would be the doctor in a specific, individual situation to decide whether the patient needs classical treatment before or a more modern treatment right away, because it is a more severe form of the disease. Medicine, of course, is based on the facts. Each patient is individual and the decision should be individual. Drug programs as such limit this possibility of individualization to some extent, which is not entirely consistent with the idea of providing health services in the modern world. But I think we have to be happy with what is. Let's hope we have a bright future ahead of us.
Thank you for the interview
