IL-23 Inhibitors to treat psoriatic arthritis: A systematic review & meta-analysis of randomized controlled trials

Abstract

Aim: To review the available evidence on the efficacy and safety profiles of four Interleukin-23 inhibitors in patients with Psoriatic Arthritis. Methods: Several databases were searched till July 2022. A total of 11 RCTs with at least one treatment arm were included. All articles were in English. The primary outcomes were ACR20, HAQ-DI, PASI90, and TEAEs experienced by the patients. Results: Compared to other groups, Guselkumab had the strongest association with ACR20 response (RR: 2.14; 95% CI: 1.84-2.49, p < 0.00001), while a mean change in HAQ-DI (MD: -0.24; 95% CI: -0.41- -0.13, p = 0.0001) and PASI90 (RR: 9.81; 95% CI: 3.18-30.22; p <0.01) were most strongly associated with Ustekinumab. TEAEs were significantly present in the Guselkumab group (RR: 1.26; 95% CI: 1.00 - 1.59; p = 0.05). Conclusion: Although our analysis suggests that IL-23 inhibitors are efficacious at treating psoriatic arthritis, further studies are required for long-term outcomes.

Keywords

• Interleukin-23
• Ustekinumab
• Risankizumab
• Guselkumab
• Tildrakizumab
• Psoriatic arthritis