Safety of IL-23 p19 Inhibitors for the Treatment of Patients With Moderate-to-Severe Plaque Psoriasis: A Narrative Review

被引:26
作者
Blauvelt, Andrew [1 ]
Chiricozzi, Andrea [2 ,3 ]
Ehst, Benjamin D. [1 ]
Lebwohl, Mark G. [4 ]
机构
[1] Oregon Med Res Ctr, 9495 SW Locust St, Suite G, Portland, OR 97223 USA
[2] Fdn Policlin Univ A Gemelli, Dipartimento Sci Med & Chirurg, Dermatol, IRCCS, Rome, Italy
[3] Univ Cattolica Sacro Cuore, Dipartimento Med & Chirurg Traslazionale, Dermatol, Rome, Italy
[4] Icahn Sch Med Mt Sinai, Dept Dermatol, New York, NY USA
关键词
Biologics; Guselkumab; IL-23; p19; inhibitors; Psoriasis; Risankizumab; Safety; Tildrakizumab; VOYAGE; 1; GUSELKUMAB; TILDRAKIZUMAB; EFFICACY; PLACEBO;
D O I
10.1007/s12325-023-02568-0
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
The approved biologics targeting interleukin (IL)-23 p19 for the treatment of moderate-to-severe plaque psoriasis, including guselkumab, tildrakizumab, and risankizumab, have generally favorable safety profiles. The aim of the current review is to describe in detail the safety of these selective inhibitors. A literature search was performed using PubMed from inception to 1 November 2022, to identify clinical trials and real-world evidence publications using the keywords "guselkumab," "tildrakizumab," and "risankizumab." Overall, the most common adverse events (AEs) associated with IL-23 p19 inhibitors in clinical trials were nasopharyngitis, headache, and upper respiratory tract infections. Rates of serious AEs and AEs of interest, including serious infections, nonmelanoma skin cancer (NMSC), malignancies excluding NMSC, major adverse cardiovascular events, and serious hypersensitivity reactions, were not increased with long-term use in clinical trials. Selectively targeting IL-23 p19 was also not associated with elevated risk of opportunistic infections, tuberculosis reactivation, oral candidiasis, or inflammatory bowel disease. Results from real-world studies were similar, supporting the safe long-term use of these biologics in a wider population of patients with psoriasis, including older patients, patients for whom multiple biologics failed, and those with comorbidities such as obesity, metabolic syndrome, cardiovascular disease, dyslipidemia, diabetes, hypertension, and psoriatic arthritis. This review is limited by the lack of direct comparisons among therapeutic agents due to differences among study designs and safety data reporting methods. In conclusion, the favorable safety profiles of IL-23 p19 inhibitors support their long-term use in the management of patients with moderate-to-severe psoriasis.
引用
收藏
页码:3410 / 3433
页数:24
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