Comparative Efficacy and Safety of TNF-Alpha Inhibitors, IL-17 Inhibitors, and IL-23 Inhibitors in the Treatment of Moderate to Severe Psoriasis: A Systematic Review

Akaash Parthasarathi; Donald D. Savariah; Sachin Marodia; Shahpoor A. Shirzada

Comparative Efficacy and Safety of TNF-Alpha Inhibitors, IL-17 Inhibitors, and IL-23 Inhibitors in the Treatment of Moderate to Severe Psoriasis: A Systematic Review

Author(s)	Akaash Parthasarathi, Donald D. Savariah, Sachin Marodia, Shahpoor A. Shirzada
Country	India
Abstract	Psoriasis is a chronic inflammatory skin disease that significantly impacts patients' quality of life. The advent of biological therapies has revolutionized the treatment landscape for moderate to severe psoriasis, offering targeted mechanisms of action with higher efficacy and improved safety profiles compared to traditional systemic treatments. This systematic review aims to evaluate and compare the efficacy and safety of three major classes of biologics: TNF-alpha inhibitors, IL-17 inhibitors, and IL-23 inhibitors. We conducted a comprehensive search of PubMed, MEDLINE, and Cochrane Library databases for randomized controlled trials (RCTs) and observational studies published between 2015 and 2023. A total of 30 studies involving over 15,000 patients were included. The primary outcomes assessed were the Psoriasis Area and Severity Index (PASI) 75, 90, and 100 response rates and safety profiles. IL-23 inhibitors demonstrated the highest efficacy, with superior PASI 90 and PASI 100 responses, followed by IL-17 inhibitors. TNF-alpha inhibitors, while effective, showed lower PASI 90 and PASI 100 response rates but had a well-established long-term safety profile. IL-17 inhibitors were associated with higher rates of candidiasis, while IL-23 inhibitors had fewer adverse events overall. This review supports the use of IL-23 inhibitors as the most effective biological therapy for moderate to severe psoriasis, with IL-17 inhibitors as a strong alternative. TNF-alpha inhibitors remain a viable option, particularly for patients with comorbid conditions where their safety profile is well-documented.
Keywords	TNF-Alpha Inhibitors, IL-17 Inhibitors, IL-23 Inhibitors , Psoriasis
Field	Medical / Pharmacy
Published In	Volume 6, Issue 6, November-December 2024
Published On	2024-11-05
Cite This	Comparative Efficacy and Safety of TNF-Alpha Inhibitors, IL-17 Inhibitors, and IL-23 Inhibitors in the Treatment of Moderate to Severe Psoriasis: A Systematic Review - Akaash Parthasarathi, Donald D. Savariah, Sachin Marodia, Shahpoor A. Shirzada - IJFMR Volume 6, Issue 6, November-December 2024.

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Comparative Efficacy and Safety of TNF-Alpha Inhibitors, IL-17 Inhibitors, and IL-23 Inhibitors in the Treatment of Moderate to Severe Psoriasis: A Systematic Review

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