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Advancements in Biologic Therapy for Psoriasis: the IL-23 Inhibitors

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Abstract

Purpose of Review

The purpose of this article is to review clinical trials evaluating the efficacy and safety of IL-23 inhibitors in the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis.

Recent Findings

Guselkumab, tildrakizumab, and risankizumab have been approved for the treatment of psoriasis. Mirikizumab is still under investigation in phase 3 studies. IL-23 inhibitors show excellent efficacy and outperform other biologic therapies in multiple head-to-head trials. Network meta-analyses have demonstrated that IL-23 inhibitors have superior long-term efficacy, while IL-17 inhibitors have superior short-term efficacy. Guselkumab is the only IL-23 inhibitor approved for use in patients with psoriatic arthritis. Risankizumab and tildrakizumab are currently under investigation for psoriatic arthritis.

Summary

Phase 3 clinical studies have shown excellent efficacy and safety of IL-23 inhibitors in the treatment of psoriasis. While IL-17 inhibitors have faster onset of action, IL-23 inhibitors are more effective long-term.

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Authors and Affiliations

  1. Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA

    Edward Hadeler, Megan Mosca, Julie Hong, Nicholas Brownstone, Tina Bhutani & Wilson Liao

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  1. Edward Hadeler
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Correspondence to Edward Hadeler.

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Hadeler, E., Mosca, M., Hong, J. et al. Advancements in Biologic Therapy for Psoriasis: the IL-23 Inhibitors. Curr Derm Rep 10, 6–15 (2021). https://doi.org/10.1007/s13671-020-00325-y

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