Anti-IL17 treatment in childhood chronic rheumatic diseases

IntroductionInterleukin-17 (IL-17) is a family of cytokines that plays a key role in several rheumatic diseases in both adults and children. In the last few years, several drugs targeting IL-17 have been developed.Areas coveredWe present a review on the current state of the art regarding the use of anti-IL17 in childhood chronic rheumatic diseases. To date, the available evidence is limited and mainly focuses on juvenile idiopathic arthritis (JIA) and a specific autoinflammatory disease called deficiency of IL-36 receptor antagonist (DITRA). Recently, a randomized controlled trial resulted in the approval of secukinumab (an anti-IL17 monoclonal antibody) for JIA, due to its demonstrated efficacy and safety. Promising and potential uses of anti-IL17 in Behcet's syndrome and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome have also been described.Expert opinionIncreasing knowledge about the pathogenetic mechanisms underlying rheumatic diseases is leading to an improvement in the care of several chronic autoimmune diseases. In this scenario, anti-IL17 therapies (such as secukinumab and ixekizumab) might be an optimal choice. Recent data on the use of secukinumab in juvenile spondyloarthropathies can be a starting point for future treatment strategies in other pediatric rheumatic diseases, such as Behcet's syndrome and the chronic non-bacterial osteomyelitis disease spectrum, particularly SAPHO syndrome.