Summary

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• This summary is based on the review of 16 systematic review(s)/meta-analysis(es). ^[1-16]
• Interleukin (IL)-17 and IL-23 inhibitors, particularly guselkumab and risankizumab, demonstrated high drug survival rates, with higher survival observed in biologic-naive patients compared to experienced patients.
• Risankizumab, ixekizumab, and bimekizumab were the most effective treatments for achieving the Psoriasis Area and Severity Index (PASI) 90, with other drugs like tildrakizumab and guselkumab also effective but generally ranking lower.
• Anti-IL-17 and anti-IL-23 treatments, such as risankizumab and guselkumab, showed greater efficacy compared to non-biological agents, while tildrakizumab was less effective in comparison.
• Brodalumab and ixekizumab had the lowest number needed to treat (NNT) for PASI responses, with risankizumab demonstrating the highest efficacy for achieving PASI 90/100 after 48/52 weeks.
• Common adverse effects associated with anti-IL-23 agents, including tildrakizumab and risankizumab, were nasopharyngitis, headache, upper respiratory tract infection, and back pain, with grade 4 adverse effects reported for both drugs.
• No significant difference in the risk of serious adverse events (SAEs) was observed between the interventions and placebo across multiple studies, and risankizumab had the lowest rates of SAEs and treatment discontinuations in long-term analyses.
• IL-23p19 inhibitors, including tildrakizumab, guselkumab, and risankizumab, were noted for having the best safety profiles compared to other biologics, with tildrakizumab demonstrating favorable long-term safety over a 3-year period.
• Studies primarily included adults over 18 years with moderate-to-severe psoriasis, with a mean age around 44-45 years and high PASI scores at baseline, indicating significant disease severity.