A Review of the Efficacy and Safety for Biologic Agents Targeting IL-23 in Treating Psoriasis With the Focus on Tildrakizumab

Feras M Ghazawi; Farhan Mahmood; Leon Kircik; Yves Poulin; Marc Bourcier; Ronald Vender; Marni C Wiseman; Charles Lynde; Ivan V Litvinov

doi:10.3389/fmed.2021.702776

A Review of the Efficacy and Safety for Biologic Agents Targeting IL-23 in Treating Psoriasis With the Focus on Tildrakizumab

Front Med (Lausanne). 2021 Aug 10:8:702776. doi: 10.3389/fmed.2021.702776. eCollection 2021.

Authors

Feras M Ghazawi¹, Farhan Mahmood², Leon Kircik³, Yves Poulin⁴, Marc Bourcier⁵, Ronald Vender⁶, Marni C Wiseman⁷, Charles Lynde⁸, Ivan V Litvinov⁹

Affiliations

¹ Division of Dermatology, University of Ottawa, Ottawa, ON, Canada.
² Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
³ Department of Dermatology, Mount Sinai Hospital, New York City, NY, United States.
⁴ Division of Dermatology, Laval University, Quebec City, QC, Canada.
⁵ Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC, Canada.
⁶ Division of Dermatology, McMaster University, Hamilton, ON, Canada.
⁷ Section of Dermatology, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
⁸ Division of Dermatology, University of Toronto, Toronto, ON, Canada.
⁹ Division of Dermatology, McGill University, Montréal, QC, Canada.

Abstract

Psoriasis is a chronic and debilitating inflammatory immune-mediated skin disorder. Several cytokines including interleukin (IL)-23 were demonstrated to play a central role in the pathogenesis of this disease. Treatment options for psoriasis range from topical to systemic modalities, depending on the extent, anatomical locations involved and functional impairment level. Targeting cytokines or their cognate receptors that are involved in disease pathogenesis such as IL-12/23 (i.e., targeting the IL-12p40 subunit shared by these cytokines), IL-17A, IL-17F, IL-17RA, and TNF-α using biologic agents emerged in recent years as a highly effective therapeutic option for patients with moderate-to-severe disease. This review provides an overview of the important role of IL-23 signaling in the pathogenesis of psoriasis. We describe in detail the available IL-23 inhibitors for chronic plaque psoriasis. The efficacy, pharmacokinetic properties, and the safety profile of one of the most recent IL-23 biologic agents (tildrakizumab) are evaluated and reviewed in depth.

Keywords: IL-23; guselkumab; mirikizumab; psoriais; risankizumab; tildrakizumab; treatment; ustekinumab.

Publication types

Review