Results of Head-to-Head Trials in Psoriasis

Opinion
Video

Dr Linda Stein Gold summarizes results from head-to-head trials in plaque psoriasis.

Linda Stein Gold, MD: Our psoriasis treatments have evolved to the point where we can get moderate to severe plaque psoriasis under control to a better extent than we ever dreamed of maybe 10 or 15 years ago. And we have so many different options with different classes of medications that it's…a wonderful time for our patients. Now the IL-17 and the IL-23 inhibitors have really risen to the top, providing the best efficacy with a really good safety profile. Now we have some studies that have actually looked at these classes of medications head-to-head to try to understand better their efficacy and their timing of effect. The first study looked at secukinumab, which is an IL-17 inhibitor, vs guselkumab, which is an IL-23 inhibitor. And the primary end point of this particular study was a really high bar. It was a PASI [Psoriasis Area and Severity index] 90 at week 48. So they're looking to see which one of these drugs [will] give us the best…depth of response over the long term. And what we found was guselkumab had a statistically superior efficacy at this week 48, which was 84% compared [with] 70% for the IL-17 inhibitor. There wasn't superiority of either of these drugs at the week 12. And the second study looked at a different IL-17 inhibitor, secukinumab, as compared with guselkumab. But here the primary end point was even higher. It was a PASI 100, and they looked at an earlier time point. In this case, they looked at week 12. And here they found that secukinumab was statistically superior in hitting that complete clearance for a PASI 100, 14% vs 24% for the IL-23 inhibitor. So we have 2 really great classes of drugs. In these 2 studies, we found that, in 1 study looking at an earlier time point, week 12, looking at complete clearance, the IL-17 drug, drug was statistically superior. And in the other study looking at a different IL-17, but a long-term treatment effect, we found that the IL-23 inhibitor was statistically superior. Bottom line is we have some great options, and we really should strive to get our patients to as clear as possible.

Transcript is AI-generated and edited for clarity and readability.

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