Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis

In a phase 2 trial involving 166 patients with moderate-to-severe plaque psoriasis, risankizumab, a humanized monoclonal antibody that selectively inhibits IL-23, achieved clinical response superior to that achieved with ustekinumab, an IL-12 and IL-23 inhibitor. Psoriasis is a chronic immune-mediated inflammatory skin disease that occurs in 2% of adults; it has a substantial effect on quality of life and is associated with obesity, hypertension, diabetes mellitus, hypercholesterolemia, and the metabolic syndrome. 1 – 4 The proinflammatory cytokine interleukin-23 is thought to play a pivotal role in the pathogenesis of psoriasis by inducing and maintaining T helper (Th) 17 cells, Th22 cells, innate lymphoid cells, and the effector cytokines interleukin-17, interleukin-22, and tumor necrosis factor (TNF) α. 5 – 9 Interleukin-23 is composed of two subunits, p19 and p40. The p19 subunit is unique to interleukin-23, whereas the p40 subunit . . .