BRIAKINUMAB Human Anti-IL-12/23 Monoclonal Antibody Treatment of Psoriasis Treatment of Crohn's disease

Briakinumab (ABT-874) is a fully human monoclonal antibody targeting the p40 subunit of both interleukin-72 (IL-12) and -23 (IL-23). It is currently being studied in psoriasis and Crohn's disease. Psoriasis is an inflammatory immune-mediated disease that results in erythematous scaly plaques on the body. The pathogenesis is not fully elucidated but is likely driven by Th17 cells, which are activated by IL-23 and other pathways. There are numerous genetic associations with psoriasis, including defects in the p40 subunit of IL-72 and IL-23 and the IL-23 receptor In up to 20% of patients, psoriatic arthritis may accompany the skin disease. Phase II data and recently published phase III data show very high efficacy for briakinumab in plaque psoriasis, with a 75% improvement in the Psoriasis Area and Severity Index (PASI) in more than 80% of patients. Another anti-p40 antibody, ustekinumab, is currently approved by the FDA for psoriasis. Safety concerns include malignancies, infections and an unexpected increase in major adverse cardiac events (MACE) in briak-inumab-exposed patients compared with placebo.