Abstract | INTRODUCTION:
Psoriatic arthritis (PsA) is a complex, polygenic immune-mediated disease with varying clinical presentations involving the skin, nails, entheses, and axial/peripheral skeleton. AREAS COVERED: Pathophysiology of PsA with special focus on IL-23/IL-17 axis. Novel classes of targeted therapies for PsA. Pharmacologic properties, efficacy and safety of guselkumab, the only FDA approved agent from IL-23p19 inhibitor class. Data regarding other IL-23 inhibitors ( Ustekinumab - an IL-12/IL-23p40 inhibitor, Risankizumab and Tildrakizumab - both IL23p19 inhibitors), in the treatment of PsA. EXPERT OPINION: There are seven classes of FDA-approved therapies for the treatment of PsA. IL-23p19 inhibitors are the newest class of medications that has shown efficacy and reasonable safety profile in the treatment of PsA in phase 2 and phase 3 studies; Guselkumab is the only FDA-approved biologic for PsA within this class . While no head-to-head studies of IL-23p19 inhibitors and other PsA targeted therapies are available, the efficacy of these agents on musculoskeletal system appears to be comparable to TNF-inhibitors (TNFi), and the efficacy on the skin appears to be comparable, or modestly superior to the IL-17 inhibitors (IL-17i). With a superior safety profile compared to TNFi and IL-17i, IL-23p19 inhibitors have the potential to become a first-line biologic in the treatment of PsA.
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Authors | Raagav Mohanakrishnan, Secia Beier, Atul Deodhar |
Journal | Expert opinion on biological therapy
(Expert Opin Biol Ther)
Vol. 22
Issue 1
Pg. 59-65
(Jan 2022)
ISSN: 1744-7682 [Electronic] England |
PMID | 34092169
(Publication Type: Journal Article)
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Chemical References |
- Interleukin-23
- Tumor Necrosis Factor Inhibitors
- Ustekinumab
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Topics |
- Arthritis, Psoriatic
(drug therapy)
- Humans
- Interleukin-23
- Skin
- Tumor Necrosis Factor Inhibitors
- Ustekinumab
(therapeutic use)
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