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Does the presence of psoriatic arthritis affect your decision to use an anti-IL-17 or IL-23 drug in your psoriasis patients?

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How does the presence of psoriatic arthritis affect your decision to use an anti-IL-17 or IL-23 drug in your psoriasis patients?

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3 Answers
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Dermatology · University of Pennsylvania Perelman School of Medicine
Answered on

I tend to prefer IL-17s in patients with PsA as an indirect assessment of clinical trials suggests they are more effective than IL-23s (which fits my clinical experience) for PsA. IL-17s are also more effective for axial disease (IL-23s are not very effective in axial disease). If there is a history...

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Dermatology · Wake Forest University
Answered on

The presence of psoriatic arthritis has little to no impact on my choice between IL-23 and IL-17 treatments. For patients with bad psoriasis and no psoriatic arthritis, I tend to recommend IL-23 antagonists as the first-line treatment because of their efficacy, safety, and dosing regimen. For patien...

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Rheumatology · Vanderbilt University Medical Center
Answered on · Updated on

From a PsA standpoint, the choice between an IL-17i vs. IL-23i depends solely on whether the patient has axial involvement or not. While no head-to-head studies exist, I do not see any significant differences in peripheral joint response. Again this is on average, there may be individual differences...

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