A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab and tildrakizumab for the treatment of moderate to severe plaque psoriasis

Jawad Bilal, Adam Berlinberg, Sandipan Bhattacharjee, Jaren Trost, Irbaz Bin Riaz, Drew J.B. Kurtzman

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

Objective: To systematically analyze the efficacy and safety of interleukin (IL)-12/23, IL-17, and selective IL-23 inhibitors in moderate to severe plaque psoriasis. Methods and results: Twenty-four randomized placebo-controlled trials were included. Compared to placebo, risk ratios (RR) of achieving PASI-75 and PGA/IGA 0/1 respectively were 20.20 (95% CI 13.82–29.54, p <.00001) and 14.55 (10.42–20.31, p <.00001) for ustekinumab 90 mg, 13.75 (8.49–22.28, p <.00001) and 9.81 (5.70–16.89, p <.00001) for ustekinumab 45 mg, 17.65 (12.38–25.17, p <.00001) and 26.13 (16.05–42.53, p <.00001) for secukinumab 300 mg, 15.36 (10.76–21.94, p <.00001) and 20.91 (12.82–34.13, p <.00001) for secukinumab 150 mg, 18.22 (10.63–31.23, p <.000001) and 18.82 (10.36–34.16, p <.00001) for ixekizumab 80 mg every 4 weeks, 19.83 (11.07–35.52, p <.00001) and 20.41 (11.01–37.81, p <.00001) for ixekizumab 80 mg every 2 weeks, 14.79 (9.86–22.16, p <.00001) and 21.93 (15.52–31.01, p <.00001) for brodalumab 210 mg, 11.55 (7.77–17.18, p <.00001) and 16.59 (11.72–23.49, p <.00001) for brodalumab 140 mg, 12.40 (8.87–17.34, p <.00001) and 10.84 (7.91–14.85, p <.00001) for guselkumab 100 mg, 11.45 (7.45–17.58, p <.00001) and 10.97 (6.44–18.69, p <.00001) for tildrakizumab 200 mg, 11.02 (7.17–16.93, p <.00001) and 10.03 (6.45–15.59, p <.00001) for tildrakizumab 100 mg. Similar outcomes were seen for PASI-90. Safety was satisfactory for each therapy at any dose, but a slightly increased risk of withdrawal due to toxicity was observed in individuals receiving ixekizumab compared to placebo. Conclusion: Ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and tildrakizumab were highly efficacious and generally well-tolerated when used as treatments for moderate to severe plaque psoriasis.

Original languageEnglish (US)
Pages (from-to)569-578
Number of pages10
JournalJournal of Dermatological Treatment
Volume29
Issue number6
DOIs
StatePublished - Aug 18 2018

Keywords

  • Psoriasis
  • dermatologic agents
  • systemic therapies
  • targeted biologics

ASJC Scopus subject areas

  • Dermatology

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