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Which Biologics are Best in Psoriasis

A metanalysis of phase II, III and IV trials in moderate to severe plaque psoriasis suggests comparative efficacy biologic treatments, but that that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa were shown to have the past skin (PASI) response rates.

The meta-analysis included 60 clinical trials for short-term (up to 16 weeks) and long-term (44-60 weeks) efficacy with  brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa. Moderate to severe psoriasis was assessed by the Psoriasis Area and Severity Index assessment of 75%, 90%, and 100% responses.

 

From weeks 10 to 16, the highest PASI 90 rates were seen with

  • risankizumab-rzaa (71.6%)
  • brodalumab (70.8%)
  • ixekizumab (70.6%)
  • guselkumab (67.3%)

From weeks 44 to 60, the PASI 90 rates were:

  • risankizumab-rzaa (79.4%)
  • guselkumab (76.5%)
  • brodalumab (74.0%)
  • ixekizumab (73.9%)

These data show high level, comparative efficacy with IL-17 and IL-23 targeted biologics in moderate to severe plaque psoriasis.

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Disclosures
The author has received compensation as an advisor or consultant on this subject