IL-23 Inhibitors for Psoriasis
Purpose of Review
The purpose of this article is to review current understanding of the role of IL-23 in psoriasis and the available results to date on clinical trials establishing the efficacy and safety of IL-23 inhibitors for use in adults with moderate-to-severe plaque psoriasis.
Interleukin-23, a cytokine involved in activation and maintenance of the T-helper 17 pathway, plays a key role in the immunopathogenesis of psoriasis. While antibodies to IL-12 and IL-23 have been approved in psoriasis treatment for several years, robust evidence on the key role of IL-23 has led to the newest class of biologics for the treatment of psoriasis specifically targeting only IL-23. Guselkumab, tildrakizumab, risankizumab, and mirikizumab are fully human (guselkumab) or humanized (tildrakizumab, risankizumab, and mirikizumab) monoclonal antibodies that bind to the unique p19 subunit of IL-23. Guselkumab was recently approved for use in psoriasis, while the three others remain under investigation in clinical trials.
Early data from clinical trials shows high efficacy and low short-term safety risks of IL-23 inhibition.
KeywordsPsoriasis IL-23 IL-23p19 Biologics Guselkumab Tildrakizumab Risankizumab Mirikizumab
Compliance with Ethics Guidelines
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
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