Background and importance Risankizumab and guselkumab are anti-interleukin-23 monoclonal antibodies used for moderate to severe psoriasis (msPs).

Aim and objectives To evaluate the effectiveness and safety of interleukin-23 blockers in patients with msPs refractory to other biological agents in clinical practice.

Material and methods A descriptive retrospective study conducted from November 2017 to September 2021. All patients with msPs receiving risankizumab or guselkumab and previously treated with other biological agents were included. Electronic medical history and Farmatools application were used to record the following variables: age, sex, previous biological treatments, anti-interleukin-23 monoclonal antibodies used, therapy duration and baseline Psoriasis Area and Severity Index (PASI). Guselkumab regimen was 100 mg by subcutaneous administration at weeks 0 and 4, followed by a maintenance dose of 100 mg every 8 weeks. Risankizumab scheme was 150 mg by subcutaneous injection at weeks 0 and 4, followed by a maintenance dose of 150 mg every 12 weeks. Effectiveness endpoint was PASI90 (≥90% reduction from baseline PASI) at 16 and 52 weeks. Safety was assessed by adverse events (AE) and treatment withdrawals associated with AE.

Results Thirty-six patients were included: 40% of patients were female and 60% were male. Median age was 48 (28–82) years. The most frequent previous biologic treatments were: 94.3% patients with adalimumab, 88.6% etanercept and 77.1% ustekinumab. Median number of previous biological agents was 4 (1–6) therapies. Guselkumab was used in 65.7% of patients and risankizumab in 34.3%. Median duration of interleukin-23 blocker treatment was 12 (1–31) months. Median of baseline PASI values was 13 (7–21). PASI90 was reached by 44% of patients at week 16 and 70.6% at week 52. According to the safety profile of therapies, 17.1% of patients presented some AE. A total of 14 AE were collected: 5 hypercholesterolaemia, 3 hypertriglyceridaemia, 2 hypertransaminasemia, 2 hyperglycaemia, 1 albuminuria and 1 non-alcoholic fatty liver. No treatment withdrawals associated with AE were observed.

Conclusion and relevance The effectiveness of anti-interleukin-23 antibodies increased over time in our patients with msPs refractory to other biological agents. Almost three-quarters of patients reached PASI90 at week 52. Safety was acceptable, without treatment withdrawals.

References and/or acknowledgements None

Conflict of interest No conflict of interest