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.

中文翻译：

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IL-23 抑制治疗银屑病关节炎

摘要

介绍

银屑病关节炎 (PsA) 是一种复杂的多基因免疫介导疾病，具有不同的临床表现，涉及皮肤、指甲、肌腱和轴向/外周骨骼。

涵盖的领域

PsA 的病理生理学，特别关注 IL-23/IL-17 轴。新型 PsA 靶向疗法。guselkumab 是 FDA 批准的唯一一种 IL-23p19 抑制剂类药物的药理学特性、疗效和安全性。有关其他 IL-23 抑制剂（Ustekinumab – 一种 IL-12/IL-23p40 抑制剂、Risankizumab 和 Tildrakizumab – 均为 IL23p19 抑制剂）在 PsA 治疗中的数据。

专家意见

有七类 FDA 批准的治疗 PsA 的疗法。IL-23p19 抑制剂是最新的一类药物，在 2 期和 3 期研究中显示出治疗 PsA 的有效性和合理的安全性；Guselkumab 是该类别中唯一获得 FDA 批准的用于 PsA 的生物制剂。虽然没有关于 IL-23p19 抑制剂和其他 PsA 靶向治疗的头对头研究，但这些药物对肌肉骨骼系统的功效似乎与 TNF 抑制剂 (TNFi) 相当，并且对皮肤的功效似乎是与 IL-17 抑制剂 (IL-17i) 相当或略优于 IL-17 抑制剂。与 TNFi 和 IL-17i 相比，IL-23p19 抑制剂具有卓越的安全性，有可能成为治疗 PsA 的一线生物制剂。