Guselkumab, tildrakizumab, and risankizumab in a real-world setting: drug survival and effectiveness in the treatment of psoriasis and psoriatic arthritis

Abstract

Background

Clinical trials have shown promising results for interleukin-23 inhibitors in the treatment of psoriasis. The drugs have been used in clinical practice since 2017.

Objective

To investigate the drug survival and effectiveness of interleukin-23 inhibitors in the treatment of psoriasis and psoriatic arthritis (PsA) in a real-world setting.

Methods

The study was a retrospective analysis of patients treated with either guselkumab, tildrakizumab, or risankizumab at the Department of Dermatology, Aarhus University Hospital, during the period from June 11 2018, to July 14 2021.

Results

A total of 80 patients were included. During the study, 19 patients discontinued treatment with an interleukin-23 inhibitor, and mean treatment duration (SD) was 61.4 weeks (43.7). Seventy-six patients (95%) had previous use of ≥1 biologic. One-year drug survival was 81.0%. Among patients, 64.3% achieved a Psoriasis Area and Severity Index (PASI) ≤ 2 at weeks 12–17; 61.3%, at weeks 40–60. There was no statistically significant difference between the drugs regarding the chance of achieving PASI ≤ 2 (p>.05). Twenty-two patients (27.5%) had PsA. Among these, 40.9% and 36.4% achieved complete remission and partial remission, respectively.

Conclusions

Interleukin-23 inhibitors appear to have high and similar drug survival and effectiveness in patients with difficult-to-treat psoriasis and PsA.

Keywords:

• Guselkumab
• risankizumab
• tildrakizumab
• psoriasis

Author contributions

Concept and design: KFH. Acquisition, analysis, or interpretation of data: CDBE, KFH. Drafting of the manuscript: CDBE. Critical revision of the manuscript for important intellectual content: CDBE, LI, KFH. Statistical analysis: CDBE. Administrative, technical, or material support: LI. Supervision: KFH.

Disclosure statement

Cathrine Elgaard has received a personal scholarship from Novo Nordisk Foundation outside of the submitted work. Dr Iversen has served as a consultant and/or paid speaker for and/or participated in clinical trials sponsored by AbbVie, Almirall, Amgen, Astra Zeneca, BMS, Boehringer Ingelheim, Celgene, Centocor, Eli Lilly, Janssen Cilag, Kyowa, Leo Pharma, MSD, Novartis, Pfizer, Regranion, Samsung and Union Therapeutics UCB. Dr Hjuler has served as a consultant and advisor for the following companies: AbbVie, Bristol Myers Squibb (BMS), Janssen, LEO Pharma, UCB and Novartis, and has received speaking fees or grants from AbbVie, Eli Lilly, LEO Pharma, Novartis, and Janssen.