Photo Credit: Vdvornyk
At Maui Derm Hawaii, held January 22-26, 2024, Andrew Blauvelt, MD, MBA, presented as part of “Psoriasis Update: 2024.” Dr. Blauvelt published a paper recently in this area of study, which we summarize here.
Safety of IL-23 p19 Inhibitors for the Treatment of Patients With Moderate-to-Severe Plaque Psoriasis: A Narrative Review
Adv Ther. 2023;40(8):3410-3433.
Biologics approved for targeting interleukin (IL)-23 p19 in the treatment of moderate-to-severe plaque psoriasis, including guselkumab, tildrakizumab, and risankizumab, generally exhibit favorable safety profiles. This review aims to provide a comprehensive analysis of the safety associated with these selective inhibitors. A literature search, conducted on PubMed from inception to November 1, 2022, identified clinical trials and real-world evidence publications using the keywords “guselkumab,” “tildrakizumab,” and “risankizumab.”
Across clinical trials, the most prevalent adverse events (AEs) related to IL-23 p19 inhibitors were nasopharyngitis, headache, and upper respiratory tract infections. Long-term use in clinical trials did not show increased rates of serious AEs or AEs of interest, such as serious infections, nonmelanoma skin cancer (NMSC), malignancies excluding NMSC, major adverse cardiovascular events, and serious hypersensitivity reactions. Targeting IL-23 p19 selectively was not linked to heightened risks of opportunistic infections, tuberculosis reactivation, oral candidiasis, or inflammatory bowel disease.
Real-world studies yielded similar results, supporting the safe long-term use of these biologics in a broader population of psoriasis patients. This included older patients, individuals who had experienced failure with multiple biologics, and those with comorbidities like obesity, metabolic syndrome, cardiovascular disease, dyslipidemia, diabetes, hypertension, and psoriatic arthritis. However, the review acknowledges limitations due to the absence of direct comparisons among therapeutic agents, attributed to variations in study designs and safety data reporting methods.
In conclusion, the favorable safety profiles observed in IL-23 p19 inhibitors endorse their long-term utilization in the management of patients dealing with moderate-to-severe psoriasis.
For more information regarding Maui Derm Hawaii 2024, visit the conference website. Check here often for conference updates, psoriasis-focused abstracts and features, and more!
