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4CPS-157 Comparison of the effectiveness between interleukin-23 inhibitors for treatment of psoriasis in a third level hospital
  1. A Merchán,
  2. SC Lucía,
  3. FM Raquel,
  4. GO María de Los Reyes,
  5. PM María,
  6. AB María Ángeles,
  7. PJ María Del Puerto,
  8. VM Isabel,
  9. AM Mercedes,
  10. CP Lucía,
  11. VH José Manuel
  1. Hospital Clínico Universitario Lozano Blesa, Pharmacy, Zaragoza, Spain


Background and Importance Interleukin-23 (IL-23) is a cytokine involved in inflammatory and immune responses in psoriasis. Novel therapies such as tildrakizumab, guselkumab, and risankizumab inhibit the IL-23-receptor interaction.

Aim and Objectives To compare the effectiveness between IL-23 inhibitors in patients with psoriasis in a third level hospital.

Material and Methods An observational, retrospective, descriptive study was conducted in patients with psoriasis treated with tildrakizumab, guselkumab or risankizumab between August-20 and August-22. Demographic, clinical, and treatment specific variables were collected. Effectiveness was determined through the comparison of psoriasis area severity index (PASI) prior starting IL-23 inhibitor and after the first visit (between weeks 4 and 16 after start).

Results The study included 58 patients [62.1% men, median age 51 (23-83) years] out of whom 8 (13.8%) had psoriatic arthritis comorbidity, 11 (18.9%) were treated with tildrakizumab, 20 (34.4%) with guselkumab and 27 (46.5%) with risankizumab. Median of treatment line was 3 (2-5) with tildrakizumab and guselkumab, and 2 (1-12) with risankizumab. Adalimumab was the most common previous therapy (54.5%, n=6 for tildrakizumab; 40.0%, n=8 for guselkumab; 38.5%, n=10 for risankizumab) and the median time of treatment with previous drug was 58.4 (9.8-665.0), 64.5 (1.5-921.0) and 46.6 (0.0-299.0) weeks, respectively. Reasons for switching to IL-23 inhibitors were treatment failure (100.0%, n=11 for tildrakizumab; 85.0%, n=17 for guselkumab; 84.6%, n=22 for risankizumab), adverse events (15.0%, n=3 for guselkumab; 11.5%, n=3 for risankizumab) or drug interaction (3.8%, n=1 for risankizumab). Median time of treatment with IL-23 inhibitor was 41.9 (16.9-68.0), 44.1 (9.2-168.0) and 26.3 (14.9-96.1) weeks for tildrakizumab, guselkumab and risankizumab, respectively. Median PASI before switching to IL-23 inhibitor treatments vs after first visit were 7.7 (3.3-10.8) vs 1.4 (0.0-5.2) for tildrakizumab, 8.9 (1.0-29.1) vs 0.9 (0.0-6.8) for guselkumab and 7.8 (2.8-21.8) vs 1.2 (0.0-10.4) for risankizumab. 7 patients (35.0%) and 10 patients (37.0%) in treatment with guselkumab and risankizumab respectively achieved PASI 0, while only 3 patients (27.3%) in treatment with tildrakizumab did.

Conclusion and Relevance The duration of the previous treatment was prolonged. Treatment failure was the main reason to initiate an IL-23 inhibitor treatment. Data suggest that guselkumab and risankizumab could be more effective treatments between 4 and 16 weeks compared to tildrakizumab.

Conflict of Interest No conflict of interest

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