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Case series reveals potential for IL-17 inhibitors to improve outcomes in localized scleroderma patients, suggesting further investigation is needed.
Localized scleroderma (LSc) is an autoimmune fibrosing disorder characterized by inflammation and sclerosis of the skin and underlying soft tissues. IL-17 signaling has been implicated in active inflammatory lesions, but treatment options for severe or refractory LSc remain limited. Here, we present nine patients with LSc treated with IL-17A or IL-17 receptor A inhibitors at our institution (ixekizumab, secukinumab, or brodalumab). These biologics were administered to patients refractory to conventional therapies or anticipated to have treatment-resistant disease, following institutional approval for unapproved drug use. Five patients improved, two stabilized, and two progressed. One patient developed pustulotic arthro-osteitis during brodalumab treatment, possibly representing a paradoxical reaction; no other major adverse events were observed. Although these uncontrolled retrospective data do not establish efficacy, they suggest that IL-17 pathway inhibition merits further study in selected patients with refractory LSc.
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Takahashi et al. (2026) studied this question.
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