Real-World Efficacy of IL-23 Inhibitors in Psoriasis Affecting High-Impact Areas: Indirect Comparison of Tildrakizumab 200 mg, Risankizumab, and Guselkumab-IL PSO (Italian Landscape Psoriasis) - PubMe
6 days ago
- #Psoriasis
- #IL-23 inhibitors
- #Real-world efficacy
- Study compares real-world efficacy of IL-23 inhibitors (risankizumab, guselkumab, tildrakizumab 200 mg) in treating psoriasis affecting high-impact areas (scalp, nails, palms/soles, genitalia).
- Multicenter retrospective study included 670 patients across 37 Italian dermatology centers, evaluating effectiveness using PASI and site-specific PGA scores over 52 weeks.
- Risankizumab showed fastest and most pronounced PASI reduction, achieving PASI90 and PASI100 in 89.6% and 82.1% of patients by week 52, respectively.
- Tildrakizumab 200 mg had slower onset but comparable long-term efficacy, especially in nail and palmoplantar psoriasis.
- Complete nail clearance (fn-PGA = 0) at week 52: 90.0% (risankizumab), 76.7% (tildrakizumab), 66.7% (guselkumab).
- Palmoplantar and genital psoriasis showed near-complete resolution across all treatments by week 52.
- Scalp involvement improved markedly with all agents, with lower residual disease observed with risankizumab.
- All treatments were well tolerated, with infrequent and mild adverse events, and no major safety concerns.
- Conclusion supports personalized biologic selection based on disease localization, patient characteristics, and therapeutic goals.