Background and Importance Anti-IL-23 have emerged as safe and effective options for the treatment of msPs.

Aim and Objectives We aimed to evaluate the persistence of anti-IL-23 (guselkumab and risankizumab) in patients with msPs. Secondarily, these patients’ clinical outcomes and health-related quality of life (HRQL) and the safety profile were also assessed.

Material and Methods Retrospective observational study from January 2019 to September 2022. Patients with msPs receiving anti-IL-23 were included. Demographic (sex, age) and clinical data (previous biological treatments, therapy duration and baseline Psoriasis Area and Severity Index (PASI)) were collected from the digital medical record. Non-persistence was defined as treatment discontinuation or a treatment gap > 90 days. The cumulative probability of treatment persistence was analysed by Kaplan-Meier method. Secondary endpoint: PASI90 response at 1 year, change in HRQL through dermatology life quality index (DLQI) at 1 year, and safety profile.

Results 44 patients were included (26 women), 30 received guselkumab and 14 risankizumab. Mean age was 53.5 years. 93.2% received biologic therapies before, and 86.3% conventional systemic treatment. At data cut-off time, 73.3% and 92.8% patients remained on guselkumab and risankizumab respectively. The main cause of discontinuation was primary failure. In 13.3% of guselkumab patients, dose interval was extended >8weeks and in 7.1% of risankizumab patients was extended >12 weeks. The cumulative probability of guselkumab treatment persistence was 79.7% at 1 year and for risankizumab 92.6%. The median PASI score was 8 and 9 at guselkumab and risankizumab treatment initiation respectively. 50% of guselkumab patients and 64.3% of risankizumab patients achieved PASI90 improvement at 1 year. 44.8% of guselkumab and 71.4% of risankizumab patients achieved a minimal clinically significant difference (>4-point reduction) in DLQI score at 1 year. One patient experienced one adverse reaction (ARs) related to guselkumab: headache and two risankizumab patients experienced increase in transaminases.

Conclusion and Relevance Our cohort shows a moderate persistence rate and PASI improvement at 1 year with guselkumab and a moderate benefit in improving HRQL. High persistence rate and moderate PASI improvement was reached with Risankizumab and a substantial improvement in HQRL. No important adverse reactions were found, without treatment withdrawals.

Conflict of Interest No conflict of interest.