Drug survival and clinical effectiveness of secukinumab, ixekizumab, brodalumab, guselkumab, risankizumab, tildrakizumab for psoriasis treatment.

Summary: Background: Biologics targeting IL‐23 and IL‐17 show efficacy and safety in the treatment of moderate‐to‐severe psoriasis. Objective: To investigate drug survival in patients with psoriasis treated with biologics. Patients and methods: We performed a comparative evaluation of the achievement of PASI 90 and PASI ≤ 3 at 16, 28, and 52 weeks along with a DS (drug survival) analysis with IL‐17 and IL‐23 inhibitors brodalumab, ixekizumab, secukinumab, risankizumab, tildrakizumab, and guselkumab on 1,057 patients. Results: IL‐17 inhibitors showed a faster achievement of PASI 90 and PASI ≤ 3 with significant superiority over IL‐23 inhibitors at week 16 (p < 0.001; 56% vs. 42% and 70% vs. 59%, respectively). A difference was shown in favor of IL‐23 inhibitors regarding DS (p < 0.001), which was 88% at 24 months vs. 75% for IL‐17 inhibitors. In multivariate analysis, IL‐23 inhibitors (HR 0.54 CI 0.37–0.78, p = 0.001), and male sex (HR 0.57 CI 0.42–0.76, p < 0.001) were all associated with a lower probability of drug interruption. Risankizumab (HR 0.42 CI 0.26‐0.69, p = 0.001), guselkumab (HR 0.49 CI 0.24–0.99, p = 0.046), and male sex (HR 0.57 CI 0.43–0.77, p < 0.001) were associated with a lower probability of drug interruption than secukinumab. Conclusions: IL‐23 inhibitors showed the best performance on DS. Overall, the most effective class was IL‐17 inhibitors considering the short‐term effectiveness, but long‐term effectiveness is in favor of anti‐IL‐23. [ABSTRACT FROM AUTHOR]