To evaluate the efficacy and safety of systemic pharmacologic treatments for moderate to severe plaque psoriasis during the induction phase.
Key Findings:
IL-17 inhibitors ranked highest for efficacy, followed by IL-23, IL-12/23, and TNF inhibitors.
All systemic therapies were more effective than placebo in achieving PASI 90.
Infliximab, bimekizumab, ixekizumab, brodalumab, and risankizumab ranked highest for PASI 90 response.
Serious adverse events were uncommon with no significant differences between treatments and placebo.
Differences in onset of action were noted, with IL-17 inhibitors showing more rapid responses.
Interpretation:
Biologic therapies, especially IL-17 and IL-23 inhibitors, are the most effective options for short-term skin clearance in moderate to severe plaque psoriasis.
Limitations:
Focus on short-term outcomes may not reflect long-term safety and effectiveness.
Reporting of serious adverse events was infrequent and may not fully capture overall tolerability.
Conclusion:
The findings support the use of IL-17 and IL-23 inhibitors in reshaping expectations for psoriasis disease control.
