Background and importance Inhibitors of interleukin-23 (IL-23 inhibitors) have emerged as safe and effective options for the treatment of moderate-to-severe plaque psoriasis. These drugs are contributing to a rising standard for psoriasis outcomes through resolution of skin lesions and joint manifestations and improvement of patient quality of life

Aim and objectives To evaluate the effectiveness of IL-23 inhibitors in patients with moderate–severe chronic plaque psoriasis

Material and methods This was an observational study including patients with moderate-to-severe psoriasis who were treated for at least 36 weeks with IL-23 inhibitors. Data collected, obtained from digital clinical history, were: demographic characteristics and previous biological therapies. The severity of plaque psoriasis was assessed by the Psoriasis Area Severity (PASI). Efficacy was evaluated by estimating the proportion of patients achieving PASI 75, PASI 90 and PASI 100 responses at weeks 16, 24 and 36. Student’s t-test for paired samples was used to determine the significant difference in outcome of patients between PASI at baseline and PASI response at weeks 16, 24 and 36. Data were analysed using IBM SPSS Statistics v.19.0

Results A total of 35 patients were included, 21 women (60%), mean age 50.6±13.8 years. IL-23 inhibitors used were: guselkumab (n=26, 74%) and risankizumab (n=9, 26%). All patients had chronic plaque psoriasis. Most of them had previously been treated with a biologic agent (n=33, 94%). 5 patients (14%) discontinued the anti-IL23 therapy due to inefficiency. Mean PASI at baseline was 10.1±5. IL-23 inhibitors decreased mean PASI from baseline to 3±3.3 (p=0.003), 2±3 8 (p=0.001), 1.3±2.9 (p=0.001) at 16, 24 and 36 weeks, respectively. At 16 weeks, PASI 75, 90 and 100 response was achieved in 50%, 31.8% and 22.7% of patients; at 24 weeks, PASI 75, 90 and 100 response was achieved in 86.4%, 54.5% and 40.9%, whereas at 36 weeks, PASI 75, 90 and 100 response was achieved in 100%, 77.3% and 72.7% of patients, respectively.

Conclusion and relevance IL-23 inhibitors show great results in the management of moderate-to-severe psoriasis in adults. Results of this real-life study are consistent with the pivotal trials.

Conflict of interest No conflict of interest