RecruitingNCT06786936

Evaluating the Role of IL-17 as an Orchestrator of Peripheral-central Cross Talk in Depressive Symptoms

Sponsor

NHS Greater Glasgow and Clyde

Enrollment

50 participants

Start Date

Jun 2, 2025

Study Type

OBSERVATIONAL

Conditions

Depression Psoriatic Arthritis Psoriatic Plaque

Summary

The investigators seek clinically actionable understanding of the mechanisms that underlie depression in the context of immune mediated inflammatory diseases (IMIDs), delivered by a focused immune intervention study examining brain circuitry using state of the art imaging in the context of exquisitely specific therapeutic immune interception in human immune disease. Glutamate concentration in the NAcc will be positively correlated with the magnitude of the inflammatory response and will be attenuated by IL-17A inhibition. Ultimately, this will be associated with an improvement in depressive symptoms. The strength of coupling between early and late systems will be attenuated in the context of IL-17A-driven inflammation and will be correlated with less frequent switching behaviour following negative outcomes and ultimately depressive symptoms. This coupling will be re-established following IL-17 antagonism. Patients whose depressive symptoms benefit most from IL-17A antagonism will exhibit greatest resting-state and task-specific functional connectivity between Th-NAcc.

Eligibility

Min Age: 18 YearsMax Age: 74 Years

Plain Language Summary

Simplified for easier understanding

This study is investigating whether IL-17 — an immune system protein — links skin inflammation (from psoriasis) to depressive symptoms in the brain. Researchers will track patients with psoriasis or psoriatic arthritis who are starting a new biologic medication and measure changes in mood, brain activity, and blood markers. **You may be eligible if...** - You are between 18 and 75 years old - You have been diagnosed with psoriasis (PsO) or psoriatic arthritis (PsA) by a dermatologist or rheumatologist - Your specialist has decided to start you on secukinumab, bimekizumab, or ixekizumab as part of your regular care - You have no contraindications to MRI scanning **You may NOT be eligible if...** - You have metal implants or devices that are not MRI-compatible - You have contraindications to the biologic medications being studied - You are outside the age range Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGSecukinumab

Initial dosing of Secukinimab at week 0, 1, 2, 3, 4 and maintenance doses will be determined by the standard care team. This will be 150mg or 300mg. This will be administered by the study team once confirmed and randomisation has occurred for secukinimab/ placebo allocation.

DRUGBimekizumab

Initial dosing of bimkizumab at week 0 \& 4 and maintenance doses will be determined by the standard care team. This will be 160mg or 320mg. This will be administered by the study team once confirmed and randomisation has occurred for bimekizumab/ placebo allocation.

DRUGIxekizumab

Initial dosing of Ixekizumab at week 0 \& 4 or week 0, 2 \& 4, maintenance doses will be determined by the standard care team. The initial dose will be 160mgs then 80mg dose will either be given 2 or 4 weekly. This will be administered by the study team once confirmed and randomisation has occurred for Ixekizumab/ placebo allocation.

DRUGPlacebo

Sodium chloride 0.9% for injection will be used as a placebo. A 1ml volume will be drawn up into a suitable sized syringe and labelled in accordance with standard practice at site. The dose will be administered as a subcutaneous injection in line with the Secukinumab/ Bimekizumab/ Ixekizumab dosing regimen. No dose adjustments are permitted.