Serum levels of IL-17 and IL-22 are reduced by etanercept, but not by acitretin, in patients with psoriasis: a randomized-controlled trial.

Author(s): Caproni M, Antiga E, Melani L, Volpi W, Del Bianco E, Fabbri P

Affiliation(s): Department of Dermatological Sciences, University of Florence, Florence, Italy.

Publication date & source: 2009-03, J Clin Immunol., 29(2):210-4. Epub 2008 Sep 2.

Publication type: Randomized Controlled Trial

INTRODUCTION: There are no controlled trials comparing etanercept and acitretin efficacy and therapeutic mechanisms in psoriasis. MATERIALS AND METHODS: In the present study, 30 patients were given etanercept 50 mg twice weekly and 30 patients acitretin 0.4 mg/kg per day, both for 12 weeks. Before and after treatment, psoriasis area and severity index was calculated, and serum levels of interleukin (IL)-17, IL-22, and IL-23 were investigated. RESULTS: After treatment, psoriasis area and severity index was significantly lower for both groups. However, etanercept-treated patients showed lower psoriasis area and severity index than acitretin-treated ones. Psoriasis patients showed higher IL-17 and IL-22 levels than controls, while no IL-23 was found in any serum. Furthermore, a correlation between IL-17 levels and psoriasis severity was found. Only etanercept was able to reduce IL-17 and IL-22 levels. CONCLUSIONS: Our findings suggest that etanercept is more effective than acitretin in the treatment of psoriasis and that it is able to affect Th17 system.