Efficacy, safety, and drug survival of IL-23, IL-17, and TNF-alpha inhibitors for psoriasis treatment: a retrospective study

Abstract

Background

Real-life studies in psoriasis are lacking. Many monoclonal antibodies targeting tumor-necrosis factor (TNF)-alpha, interleukin 17, and 23 are approved drugs for psoriasis treatment.

Objectives

To compare the short and long-term efficacy, safety, and drug survival of anti TNF-alpha, anti-IL-17, and anti-IL-23 in a large case series.

Methods

Psoriasis area severity index (PASI) and retention rates for adalimumab, secukinumab, guselkumab, ixekizumab, and brodalumab were analised.

Results

A total of 263 patients were randomly selected among the five drugs register of the patients attending the Psoriasis Unit at the Turin University Hospital. The mean PASI at baseline was 14.3. Ixekizumab showed a significantly higher efficacy profile compared to other drugs in terms of PASI90 and PASI100 at week 12, 24, and week 48 even when adjusted for other confounding factors. This superiority was not followed by an expected higher drug survival. On the contrary, secukinumab was the only drug that showed a higher drug survival among bio-naïve patients.

Keywords:

• Psoriasis
• biological therapy
• PASI
• drug survival

Ethical approval

The study was approved by the ethics committee of Turin University hospital (IT10771180014 SS-Dermo20).

All the participants read and signed informed consent.

Disclosure statement

The authors report no conflict of interest. Data available upon reasonable request. All authors participated in the drafting and revision of the work. All authors read and approved the manuscripts and give consent for publication.