How do IL-23 and IL-17 Inhibitors Differ in Clinical Efficacy

Join Audrey Gibson, PA-C, from the Arthritis Center of North Georgia, as she explores the latest clinical comparisons between IL-17 and IL-23 inhibitors in managing moderate-to-severe plaque psoriasis (PsO) and psoriatic arthritis (PsA).

The ECLIPSE trial, published in The Lancet, compared Guselkumab (IL-23 inhibitor) vs. Secukinumab (IL-17 inhibitor) over 48 weeks. Guselkumab showed superior long-term efficacy, with 84% of patients achieving PASI 90 (90% skin clearance) compared to 70% with Secukinumab, both with similar safety profiles.

The EXCEED trial compared Ixekizumab (IL-17) and Guselkumab (IL-23) over 24 weeks. Ixekizumab provided a faster onset of symptom relief, particularly in nail psoriasis, while Guselkumab delivered sustained disease control. In PsA patients, both drugs showed similar joint symptom improvement, reinforcing their viability in treatment.

For rapid symptom relief, IL-17 inhibitors (Ixekizumab, Secukinumab) may be preferable. For long-term stability, IL-23 inhibitors (Guselkumab) stand out. The choice depends on patient needs, disease progression, and treatment goals.

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