Recent Safety and Efficacy Data for Biologics in Psoriasis
Treatment options for plaque psoriasis have proliferated significantly in the past decade, with an influx of biologics. With these seemingly interchangeable options, the main criteria that most practitioners use for choosing a treatment are efficacy, safety, and coverage. While coverage is difficult to speak to broadly, safety and efficacy are crucial to address. In the past several years, numerous pivotal studies have been published that shed light on the safety and efficacy of multiple IL-17 and IL-23 treatments.
Not all IL-17 biologics are created equal. As such, it is important to consider the efficacy and, more importantly, the side effects of each. Bimekizumab, the newest of the IL-17s, is novel in that it targets both IL-17A and IL-17F. In a modified Delphi process, an expert panel discusses the available literature on Bimekizumab, including a safety profile examining risks of candidiasis, suicidality, and incidence of inflammatory bowel disease.1 An important consideration in determining appropriate treatment is efficacy in challenging areas, such as the palmoplantar areas, face, scalp, and nails. To address this concern, Gottlieb et al discuss the role of ixekizumab, which targets IL-17A, over a 5-year period.2 Finally, to address concerns with brodalumab, which also targets IL-17A, Lebwohl et al conducted a 4-year pharmacovigilance report to assess serious adverse effects, including suicidal ideation and serious infections.3
Regarding IL-23 biologics, Daniele et al detail why certain IL-23s are superior for psoriasis patients. The authors discuss drug binding as well as a common consideration of switching between IL-23 treatments. Within the IL-23s, tidrakizumab has shown real-world efficacy over a 64-week period.5 Similarly, guselkumab has shown real-world improvement in moderate-to-severe plaque psoriasis patients over a 104-week period.6 Gargiulo et al further detail efficacy and safety data in obese and overweight patients.
Psoriasis treatments continue to proliferate, with new mechanisms of action as well as variations on existing mechanisms. With this constant evolution, it is important to stay current with the safety and efficacy data for each.
Interested in reading more? Check out the referenced articles:
- Burshtein J, Shah M, Zakria D, et al. Safety of bimekizumab for plaque psoriasis: an expert consensus panel. J Drugs Dermatol. 2024;23(8):592-599.
- Gottlieb AB, Armstrong A, Blauvelt A, et al. Benefits over five years of ixekizumab treatment in patients with psoriasis involving challenging body areas. J Drugs Dermatol. 2024;23(8):619-625.
- Lebwohl M, Koo J, Leonardi C, et al. Brodalumab: 4-year US pharmacovigilance report. J Drugs Dermatol. 2023;22(4):419-422.
- Daniele SG, Galimberti F, Bunick CG. Structural insights: what makes some IL-23 biologics more effective in psoriasis. J Drugs Dermatol. 2024;23(10):903-904.
- Heim J, Vasquez JG, Bhutani T, et al. Tildrakizumab real-world effectiveness and safety over 64 weeks in patients with moderate-to-severe plaque psoriasis. J Drugs Dermatol. 2024;23(8):612-618.
- Gargiulo L, Ibba L, Cortese A, et al. Real-life effectiveness and safety of guselkumab in moderate-to-severe plaque psoriasis: A 104-week retrospective single-center study. J Drugs Dermatol. 2024;23(8):632-639.
