Background and Importance Anti-interleukin 23 drugs were approved in the last 5 years. The absence of comparison between alternatives such as risankizumab (RIS) or guselkumab (GUS) needs to be fulfilled.

Aim and Objectives To evaluate the effectiveness through indirect comparisons of risankizumab and guselkumab in plaque psoriasis.

Material and Methods Multicentric, retrospective and observational study. Comparison made with plaque psoriasis patients with active treatment with risankizumab or guselkumab from June 2021 and June 2022. Demographic (sex, age) and clinical (body surface area (BSA), psoriasis area severity index (PASI) at baseline and in subsequent dermatology controls, PASI clearance (PASI100)) data collected. Comparison made through PASI100 and BSA and PASI reduction.

Results 59 patients treated with RIS, 64% men, 52,4 ± 15,3 SD years old averaged, and BSA and PASI of 11,4 ± 8,2 SD and 8,7 ± 4,2 SD respectively at baseline. 49 patients treated with GUS, 59,2% men, 50,9 ± 12,1 SD years old averaged, and BSA and PASI of 10,25 ± 10,27 SD and 8 ± 6,69 SD respectively at baseline.

RIS achieved at mean 21,6 ± 15,7 SD weeks a BSA and PASI of 2,24 ± 6 SD and 1,81 ± 3,7 SD respectively, with PASI100 reached by 46% of patients. GUS achieved at mean 22,9 ± 13,1 SD weeks a BSA and PASI of 3,87 ± 9,28 SD and 2,89 ± 4,26 SD respectively, with PASI100 reached by 45%.

At 39,5 ± 10,8 SD weeks, RIS obtained BSA 0,66 ± 1,27 SD and PASI 0,64 ± 1,01 SD, with PASI100 in 64% of patients, while GUS obtained BSA 1,82 ± 3,28 SD and PASI 1,89 ± 3,3 SD, with PASI100 in 50% of patients in 44,6 ± 17,5 SD weeks.

After 63,6 ± 14,5 SD weeks, RIS achieved BSA 0,68 ± 0,94 SD and PASI 0,9 ± 1,14 SD, and PASI100 maintained by 57% patients. GUS achieved BSA 0,95 ± 1,55 SD and PASI 0,53 ± 0,92 SD, and PASI100 maintained by 67% patients.

Conclusion and Relevance RIS and GUS are effective alternatives for plaque psoriasis treatment, although it seems that after a year, the activity of RIS starts to decrease. Further studies should be performed to determine this hypothesis.

Conflict of Interest No conflict of interest