What question did this study set out to answer?

This analysis aims to assess the real-world effectiveness of IL-23 inhibitors in treating psoriasis, especially in high-impact areas.

February 19, 2026Dermatology and Therapy0 citationsOpen Access

Real-World Efficacy of IL-23 Inhibitors in Psoriasis Affecting High-Impact Areas: Indirect Comparison of Tildrakizumab 200 mg, Risankizumab, and Guselkumab—IL PSO (Italian Landscape Psoriasis)

ETE. Trovato RPRoberto Perinti FGFrancesca Maria Gaiani

Key Points

This analysis aims to assess the real-world effectiveness of IL-23 inhibitors in treating psoriasis, especially in high-impact areas.
Conducted an indirect comparison of IL-23 inhibitors: tildrakizumab, risankizumab, and guselkumab.
Evaluated patient outcomes based on treatment responses and disease characteristics.
Analyzed the impact of BMI and disease resistance on treatment efficacy.
Both tildrakizumab and risankizumab showed sustained efficacy in high-impact psoriasis.
Risankizumab achieved faster and deeper treatment responses compared to tildrakizumab.
Tildrakizumab was effective for patients with higher BMI and more stubborn diseases.

Abstract

In real-world clinical practice, IL-23p19 inhibitors provide high and sustained efficacy in psoriasis affecting high-impact sites. Risankizumab offers faster and deeper responses, while tildrakizumab 200 mg represents an effective long-term option, particularly in patients with higher BMI or more treatment-resistant disease. These findings support a personalized approach to biologic selection based on disease localization, patient characteristics, and therapeutic goals.

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