Clinical effectiveness of IL-17 and IL-23 inhibitors on difficult-to-treat psoriasis areas (scalp, genital, and palmoplantar sites): a retrospective, observational, single-center, real-life study

ABSTRACT

Introduction

Psoriasis affecting the genital, palmoplantar, and scalp regions is recognized as difficult-to-treat, and data on the efficacy of biologics in these areas remains limited.

Research design and methods

This single-center study evaluated the effectiveness of anti-IL-17 and anti-IL-23 agents on scalp, genital, and palmoplantar psoriasis. We retrospectively analyzed data from all patients with psoriasis being treated with IL inhibitors at our clinic. Effectiveness was evaluated at 16, 28, and 52 weeks, according to the achievement of relative and mean PSSI, PGA-G, and ppPASI.

Results

In all, 308 patients showed involvement of the scalp, 136 in the genital area, and 94 in the palmoplantar regions. On scalp psoriasis, anti-IL-17 agents demonstrated superiority in disease control compared to anti-IL-23 agents. PSSI100 at week 16 was reached by 59% of patients on an anti-IL17 vs 39.8% on an anti-IL-23 (p < 0.003). At genital sites, no significant differences between anti-IL-17 and anti-IL-23 agents were observed, and all classes achieved PGA-G 0/1. No significant differences between anti-IL-17 and anti-IL-23 agents were observed in palmoplantar areas.

Conclusions

The present data support the utility of both anti-IL-17 and anti-IL-23 agents for the treatment of difficult-to-treat areas in patients with psoriasis. Anti-IL-17 agents achieved better control of scalp psoriasis.

KEYWORDS:

• Psoriasis
• scalp
• palmoplantar psoriasis
• genitals psoriasis
• difficult-to-treat areas
• biologics
• IL-23 inhibitors
• IL-17 inhibitors
• biological therapy

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

This study protocol was reviewed and approved by our Institutional Review Board (IRB): Comitato Etico Interaziendale A.O.U. Città della Salute e della Scienza di Torino – A.O. Ordine Mauriziano di Torino – A.S.L. Città di Torino, approval number ss-DERMO20. All patients provided written informed consent.

Author contribution

Conceptualization: L Mastorino, S Ribero, P Dapavo; Methodology: L Mastorino; Software: L Mastorino; Validation, L Mastorino, S Ribero; Formal analysis: S Ribero, L Mastorino; Investigation: L Mastorino, V Celoria, L Burzi, A Fazio, F Rosset, N Macagno, G Frigatti, G Roccuzzo, C Cariti, S Susca, M Ortoncelli, A Verrone, E Stroppiana; Resources, P Quaglino, P Dapavo; Data curation: L Mastorino, S Ribero; Writing (original draft preparation): L Burzi; Writing (review and editing): L Mastorino, L Burzi, S Ribero; Visualization: P Dapavo, L Mastorino; Supervision: S Ribero, P Quaglino; Project administration, S Ribero, L Mastorino; Funding acquisition: P Quaglino, S Ribero. All authors have read and agreed to the published version of the manuscript.

Data availability statement

Data are available from the corresponding author upon reasonable request.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.