Visual abstract | A retrospective study of IL-17 vs IL-23 inhibitors in erythrodermic and pustular psoriasis

The Psoriasis and Psoriatic Arthritis Hub is pleased to present a visual abstract representing data from a multicenter, retrospective study that investigated the efficacy and safety of IL-17 and IL-23 inhibitors in erythrodermic psoriasis (EP) and pustular psoriasis (PP). Currently, data are lacking on the use of IL-17 and IL-23 inhibitors in these rarer forms of psoriasis, although there is evidence that IL-17 inhibitors can effectively treat both EP and PP.¹

For this study, data were obtained between 2019 and 2022 from two Italian referral centers (the Dermatology Clinic at the Turin University Hospital and the Dermatology Unit at Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan), with a total of 86 patients included.¹ 27 patients had EP and 59 had PP. Baseline patient characteristics were similar across disease type and treatment groups, with the exception of higher Psoriasis Area and Severity Index scores (median, 15.0; interquartile range [IQR], 10.0–19.0 vs median, 8.2; IQR, 6.0–13.5; p = 0.009) and a lower incidence of psoriatic arthritis (51% vs 81%; p = 0.043) in patients with PP who received IL-17 inhibitors compared with those who received IL-23 inhibitors.¹ It is assumed that some EP patients may have received both IL-17 and IL-23 inhibitors at the same time, due to the baseline patient characteristics data given.

The authors noted several limitations of this study, including the lack of efficacy data for the first 12 weeks after treatment, which is common in retrospective studies, and the small sample size. Both IL-17 and IL-23 inhibitors were effective in treating EP and PP; however, further research is needed to fully elucidate there efficacy in this patient population.