Advancements in Biologic Therapy for Psoriasis: the IL-23 Inhibitors

The purpose of this article is to review clinical trials evaluating the efficacy and safety of IL-23 inhibitors in the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Guselkumab, tildrakizumab, and risankizumab have been approved for the treatment of psoriasis. Mirikizumab is still under investigation in phase 3 studies. IL-23 inhibitors show excellent efficacy and outperform other biologic therapies in multiple head-to-head trials. Network meta-analyses have demonstrated that IL-23 inhibitors have superior long-term efficacy, while IL-17 inhibitors have superior short-term efficacy. Guselkumab is the only IL-23 inhibitor approved for use in patients with psoriatic arthritis. Risankizumab and tildrakizumab are currently under investigation for psoriatic arthritis. Phase 3 clinical studies have shown excellent efficacy and safety of IL-23 inhibitors in the treatment of psoriasis. While IL-17 inhibitors have faster onset of action, IL-23 inhibitors are more effective long-term.