The benefits of interleukin inhibitors vary by agent and include increased drug survival and earlier attainment of Psoriasis Area Severity Index scores.
At the 2023 Fall Clinical Dermatology conference, a group of five panelists discussed the benefits of interleukin (IL) inhibitors for patients with psoriasis. April Armstrong, MD, MPH, and colleagues examined both IL-17 and IL-23 inhibitors in their discussion.
A study published in the Journal of the German Society of Dermatology shows that IL inhibitors are effective treatments for psoriasis, with multiple agents available that provide good short-term and long-term efficacy. Simone Ribero MD, PhD, and colleagues included both IL-17 and IL-23 inhibitors in their research, examining therapeutic outcomes with these agents among patients with psoriasis.
Dr. Ribero and colleagues conducted a comparative evaluation of attaining Psoriasis Area Severity Index (PASI) 90 and PASI≤3 at weeks 16, 28, and 52 with IL-17 and IL-23 inhibitors as well as a drug survival analysis for both classes of agents.
Differences in Drug Survival & Time to PASI Scores
The analysis included 1,057 patients (65.2% men; mean age, 54.69). The mean age at the time of psoriasis onset was 35.05. The study team noted cardiovascular comorbidities in 40.0% of patients. Study results showed nearly the same percentage (38.8%) were active smokers. More patients were treated with IL-17 inhibitors (61.3%) than IL-23 inhibitors (38.7%).
Patients treated with IL-17 inhibitors achieved PASI90 and PASI≤3 scores quicker when compared with patients treated with IL-23 inhibitors and with superiority versus IL-23 inhibitors at week 16 (P<0.001).
However, Dr. Ribero and colleagues reported a difference favoring IL-23 inhibitors for drug survival (P<0.001). At 24 months, drug survival with IL-23 inhibitors was 88% compared with 75% for IL-17 inhibitors.
Multivariate analysis demonstrated that IL-23 inhibitors (HR, 0.54; P=0.001) and male sex (HR, 0.57; P<0.001) were associated with a lower probability of drug interruption.
Both IL-17 & IL-23 Inhibitors Effective in Psoriasis
The study is the largest single-center case series to date to examine the effectiveness and survival associated with all IL-17 and IL-23 inhibitors and compare overall data within certain categories, such as sex, according to the researchers. It is also the first to include tildrakizumab, Dr. Ribero and colleagues noted.
The findings echo those of Dr. Armstrong and colleagues. In her discussion with PW about the panel, Dr. Armstrong said, “The good news is that, for many patients, both IL-17 and IL-23 inhibitors will work great.”
Click here to read more coverage of the 2023 Fall Clinical Dermatology Conference.
