4CPS-157 Comparison of the effectiveness between interleukin-23 inhibitors for treatment of psoriasis in a third level hospital

• Published in: European journal of hospital pharmacy. Science and practice 2023-03, Vol.30 (Suppl 1), p.A74-A74
• Main Authors: Merchán, A, Lucía, SC, Raquel, FM, María de Los Reyes, GO, María, PM, María Ángeles, AB, María Del Puerto, PJ, Isabel, VM, Mercedes, AM, Lucía, CP, José Manuel, VH
• Format: Article
• Language: English
• Subjects: Conflicts of interest; Cytokines; Psoriasis; Section 4: Clinical pharmacy services
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.156

Background and ImportanceInterleukin-23 (IL-23) is a cytokine involved in inflammatory and immune responses in psoriasis. Novel therapies such as tildrakizumab, guselkumab, and risankizumab inhibit the IL-23-receptor interaction.Aim and ObjectivesTo compare the effectiveness between IL-23 inhibitors in patients with psoriasis in a third level hospital.Material and MethodsAn observational, retrospective, descriptive study was conducted in patients with psoriasis treated with tildrakizumab, guselkumab or risankizumab between August-20 and August-22. Demographic, clinical, and treatment specific variables were collected. Effectiveness was determined through the comparison of psoriasis area severity index (PASI) prior starting IL-23 inhibitor and after the first visit (between weeks 4 and 16 after start).ResultsThe study included 58 patients [62.1% men, median age 51 (23-83) years] out of whom 8 (13.8%) had psoriatic arthritis comorbidity, 11 (18.9%) were treated with tildrakizumab, 20 (34.4%) with guselkumab and 27 (46.5%) with risankizumab. Median of treatment line was 3 (2-5) with tildrakizumab and guselkumab, and 2 (1-12) with risankizumab. Adalimumab was the most common previous therapy (54.5%, n=6 for tildrakizumab; 40.0%, n=8 for guselkumab; 38.5%, n=10 for risankizumab) and the median time of treatment with previous drug was 58.4 (9.8-665.0), 64.5 (1.5-921.0) and 46.6 (0.0-299.0) weeks, respectively. Reasons for switching to IL-23 inhibitors were treatment failure (100.0%, n=11 for tildrakizumab; 85.0%, n=17 for guselkumab; 84.6%, n=22 for risankizumab), adverse events (15.0%, n=3 for guselkumab; 11.5%, n=3 for risankizumab) or drug interaction (3.8%, n=1 for risankizumab). Median time of treatment with IL-23 inhibitor was 41.9 (16.9-68.0), 44.1 (9.2-168.0) and 26.3 (14.9-96.1) weeks for tildrakizumab, guselkumab and risankizumab, respectively. Median PASI before switching to IL-23 inhibitor treatments vs after first visit were 7.7 (3.3-10.8) vs 1.4 (0.0-5.2) for tildrakizumab, 8.9 (1.0-29.1) vs 0.9 (0.0-6.8) for guselkumab and 7.8 (2.8-21.8) vs 1.2 (0.0-10.4) for risankizumab. 7 patients (35.0%) and 10 patients (37.0%) in treatment with guselkumab and risankizumab respectively achieved PASI 0, while only 3 patients (27.3%) in treatment with tildrakizumab did.Conclusion and RelevanceThe duration of the previous treatment was prolonged. Treatment failure was the main reason to initiate an IL-23 inhibitor treatment. Data suggest that guselkumab and risan