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This refers to the combined use or co-inhibition of interleukin 17 (IL-17) and interleukin 23 (IL-23), two key cytokines involved in the pathogenesis of several immune-mediated inflammatory diseases, most notably moderate-to-severe plaque psoriasis and psoriatic arthritis. Both are targets for biologic therapies, but as of now there is no single approved pharmaceutical product that combines both mechanisms in one drug; rather, this term typically refers to either sequential or concurrent use of separate monoclonal antibodies targeting each pathway. IL-17 inhibitors (such as secukinumab, ixekizumab, brodalumab) block the activity of pro-inflammatory cytokine IL-17A or its receptor. IL-23 inhibitors (such as guselkumab, risankizumab, tildrakizumab) target the p19 subunit unique to IL-23 and suppress Th17 cell activation upstream from IL-17 production[1][2][3][4][6]. Both classes are highly effective for psoriasis and psoriatic arthritis; however, they have distinct safety profiles and long-term efficacy characteristics[4][6]. Combination therapy is not standard clinical practice due to overlapping mechanisms but may be considered experimentally or off-label in refractory cases.
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