A model analysis to measure the adherence of Etanercept and Fezakinumab therapy for the treatment of psoriasis

This article deals with a immunological model, which includes multiple classes of T cells, namely, the naive T cell, type I, type II and type 17 T helper cells (Th1, Th2, Th17), regulatory T cell (Treg) along with the activated natural killer cells (NK cells) and epidermal keratinocytes. In order to describe the etiology of psoriasis development, we have studied the basic mathematical properties of the model, existence and stability of the interior equilibrium. We have also derived the drug-induced mathematical model using impulse differential equation to determine the effects of combined biologics Etanercept (TNF-α inhibitor) and Fezakinumab (IL-22 monoclonal antibody) therapy considering perfect dosing during the inductive phase. We have determined the required dosing interval of both drugs to maintain the keratinocytes concentration below a threshold level. This study shows that Etanercept alone could theoretically maintain the keratinocytes level, whereas frequent dosing of Fezakinumab alone may not be enough to control the hyper-proliferation of keratinocytes. Furthermore, combination of the drugs with perfect dosing has the noticeable effect on keratinocytes dynamics, which may be suitable therapeutic approaches for treatment of psoriasis.